The Effect of Pre-existing Advanced Osteoarthritis in Trochanteric Femoral Fractures on Post-intramedullary Nailing Quality of Life - A Retrospective Study.

Abstract

Background: The functional outcome in patients with preexisting osteoarthritis after surgically treated trochanteric fracture is not yet fully elucidated. As the global population ages, the coexinsting of degenerative joint osteoarthritis and fragility fractures is increasing. Consequently, it is imperative to provide affected patients with information regarding the anticipated clinical outcomes. The objective of this study is to examine the impact of preexisting hip osteoarthritis in elderly patients on the clinical outcome following trochanteric fracture fixation.

Methods: In this retrospective single-center study elderly patients aged ≥70 years who underwent intramedullary nailing between January 2016 and March 2023 have been analysed. The severity of hip osteoarthritis was stratified into two categories: grade 0-II and grade III-IV, according to the Kellgren-Lawrence classification system. Radiological signs of consolidation were ascertained. A comprehensive evaluation of the patients' demographics and patient-reported outcome measures (Oxford Hip Score, WOMAC-score, and SF-36-score) was conducted, followed by a thorough statistical analysis, with a significance set at P < 0.05.

Results: 21 patients with 23 affected hips were included (mean age 81 ± 7.5 years; 81% female) with a mean follow-up duration of 15.1 ± 13.8 months. Patients with advanced OA (KL III-IV) reported significantly lower Oxford Hip Scores (33.3 ± 6.3 vs 43.1 ± 6.7; P = 0.003), and higher total WOMAC and WOMAC pain scores (P = 0.016 and P = 0.003).

Conclusion: The severity of pre-existing osteoarthritis of the hip in patients with intertrochanteric fractures is a significant risk factor, potentially leading to a diminished quality of life postoperatively. Further studies are necessary to provide therapeutic guidance.