Victoria Houel, Gauthier Marchasson, Nassima Ramdane, Cécile Philippoteaux, Julien Paccou
{"title":"股骨假体周围骨折的患者是通常诊断为骨质疏松症的老年人。","authors":"Victoria Houel, Gauthier Marchasson, Nassima Ramdane, Cécile Philippoteaux, Julien Paccou","doi":"10.1007/s00198-025-07486-1","DOIUrl":null,"url":null,"abstract":"<p><p>This study focused on individuals aged ≥ 50 years with periprosthetic femoral fractures (PFF). When compared to those with native hip fractures, patients with PFF were older, had a higher BMI, and demonstrated a greater number of comorbidities. Given the high frequency of osteoporosis risk factors and the BMD results, PFF should be classified as osteoporotic fractures.</p><p><strong>Introduction: </strong>To compare patients presenting with periprosthetic femoral fractures (PFF) to patients with native hip fractures with a special focus on bone mineral density (BMD) measurements, in order to reinforce the hypothesis that PFF are osteoporotic fractures.</p><p><strong>Methods: </strong>A retrospective, single-centre, observational study of all patients aged ≥ 50 years with low-energy PFF identified at the Lille University Hospital from January 1, 2016, to December 31, 2022, was conducted. The PFF group was compared to a group of patients with native hip fractures hospitalized during the same period. To compare the T-score data, we used a linear mixed model that considered a predefined adjustment for age, sex, and BMI. Adjusted means ± standard error of the mean (SEM) are derived from the mixed model.</p><p><strong>Results: </strong>Among 71 patients with PFF (78.9% female, median (IQR) age 81 (72-88) years), osteoarthritis (57.8%) was the primary indication for hip surgery. Compared with the native hip fracture group (n = 117), patients in the PFF group were significantly older (p = 0.002), had a significantly greater BMI (p = 0.043), and had a higher history of multiple falls (54.3% vs. 26.1%, p < 0.001). A greater frequency of previous low-energy fractures (69.0% vs. 44.0%, p < 0.001) and an increased prescription of anti-osteoporosis medications (26.8% vs. 11.1%, p = 0.006) in patients with PFF were found. Adjusted T-scores differed between the two groups at the lumbar spine (mean adjusted ± SEM, - 0.5 ± 0.2 (PFF group) vs. - 1.2 ± 0.2 (comparator group), p = 0.008) but not at the femoral neck or at the total hip.</p><p><strong>Conclusion: </strong>Low-energy PFF should be considered as an osteoporotic fracture and treated accordingly.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1061-1068"},"PeriodicalIF":4.2000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122641/pdf/","citationCount":"0","resultStr":"{\"title\":\"Patients with periprosthetic femoral fractures are older adults who are commonly diagnosed with osteoporosis.\",\"authors\":\"Victoria Houel, Gauthier Marchasson, Nassima Ramdane, Cécile Philippoteaux, Julien Paccou\",\"doi\":\"10.1007/s00198-025-07486-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This study focused on individuals aged ≥ 50 years with periprosthetic femoral fractures (PFF). When compared to those with native hip fractures, patients with PFF were older, had a higher BMI, and demonstrated a greater number of comorbidities. Given the high frequency of osteoporosis risk factors and the BMD results, PFF should be classified as osteoporotic fractures.</p><p><strong>Introduction: </strong>To compare patients presenting with periprosthetic femoral fractures (PFF) to patients with native hip fractures with a special focus on bone mineral density (BMD) measurements, in order to reinforce the hypothesis that PFF are osteoporotic fractures.</p><p><strong>Methods: </strong>A retrospective, single-centre, observational study of all patients aged ≥ 50 years with low-energy PFF identified at the Lille University Hospital from January 1, 2016, to December 31, 2022, was conducted. The PFF group was compared to a group of patients with native hip fractures hospitalized during the same period. To compare the T-score data, we used a linear mixed model that considered a predefined adjustment for age, sex, and BMI. Adjusted means ± standard error of the mean (SEM) are derived from the mixed model.</p><p><strong>Results: </strong>Among 71 patients with PFF (78.9% female, median (IQR) age 81 (72-88) years), osteoarthritis (57.8%) was the primary indication for hip surgery. Compared with the native hip fracture group (n = 117), patients in the PFF group were significantly older (p = 0.002), had a significantly greater BMI (p = 0.043), and had a higher history of multiple falls (54.3% vs. 26.1%, p < 0.001). A greater frequency of previous low-energy fractures (69.0% vs. 44.0%, p < 0.001) and an increased prescription of anti-osteoporosis medications (26.8% vs. 11.1%, p = 0.006) in patients with PFF were found. Adjusted T-scores differed between the two groups at the lumbar spine (mean adjusted ± SEM, - 0.5 ± 0.2 (PFF group) vs. - 1.2 ± 0.2 (comparator group), p = 0.008) but not at the femoral neck or at the total hip.</p><p><strong>Conclusion: </strong>Low-energy PFF should be considered as an osteoporotic fracture and treated accordingly.</p>\",\"PeriodicalId\":19638,\"journal\":{\"name\":\"Osteoporosis International\",\"volume\":\" \",\"pages\":\"1061-1068\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122641/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Osteoporosis International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00198-025-07486-1\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteoporosis International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00198-025-07486-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Patients with periprosthetic femoral fractures are older adults who are commonly diagnosed with osteoporosis.
This study focused on individuals aged ≥ 50 years with periprosthetic femoral fractures (PFF). When compared to those with native hip fractures, patients with PFF were older, had a higher BMI, and demonstrated a greater number of comorbidities. Given the high frequency of osteoporosis risk factors and the BMD results, PFF should be classified as osteoporotic fractures.
Introduction: To compare patients presenting with periprosthetic femoral fractures (PFF) to patients with native hip fractures with a special focus on bone mineral density (BMD) measurements, in order to reinforce the hypothesis that PFF are osteoporotic fractures.
Methods: A retrospective, single-centre, observational study of all patients aged ≥ 50 years with low-energy PFF identified at the Lille University Hospital from January 1, 2016, to December 31, 2022, was conducted. The PFF group was compared to a group of patients with native hip fractures hospitalized during the same period. To compare the T-score data, we used a linear mixed model that considered a predefined adjustment for age, sex, and BMI. Adjusted means ± standard error of the mean (SEM) are derived from the mixed model.
Results: Among 71 patients with PFF (78.9% female, median (IQR) age 81 (72-88) years), osteoarthritis (57.8%) was the primary indication for hip surgery. Compared with the native hip fracture group (n = 117), patients in the PFF group were significantly older (p = 0.002), had a significantly greater BMI (p = 0.043), and had a higher history of multiple falls (54.3% vs. 26.1%, p < 0.001). A greater frequency of previous low-energy fractures (69.0% vs. 44.0%, p < 0.001) and an increased prescription of anti-osteoporosis medications (26.8% vs. 11.1%, p = 0.006) in patients with PFF were found. Adjusted T-scores differed between the two groups at the lumbar spine (mean adjusted ± SEM, - 0.5 ± 0.2 (PFF group) vs. - 1.2 ± 0.2 (comparator group), p = 0.008) but not at the femoral neck or at the total hip.
Conclusion: Low-energy PFF should be considered as an osteoporotic fracture and treated accordingly.
期刊介绍：
An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases.
It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition.
While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.
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