1
|
Tian Z, Wei Z, Wang J, Meng C. Letter to the Editor: Geriatric distal femoral fractures: post‑operative complications and nine‑year mortality-a retrospective analysis of two tertiary trauma centres. INTERNATIONAL ORTHOPAEDICS 2024; 48:1123-1124. [PMID: 38302597 DOI: 10.1007/s00264-024-06101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Zhikang Tian
- Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Zichun Wei
- Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Jiahui Wang
- Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Chunyang Meng
- Affiliated Hospital of Jining Medical University, 89 Guhuai Rd, Jining, 272007, China.
| |
Collapse
|
2
|
Mather AM, Edwards E, Hau R, Ekegren CL. Primary and Periprosthetic Distal Femur Fractures in Older Adults: No Difference in 12-Month Mortality and Patient-Reported Outcomes. J Orthop Trauma 2023; 37:492-499. [PMID: 37296087 DOI: 10.1097/bot.0000000000002649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To compare fracture incidence, mortality, and patient-reported health outcomes at 6 and 12 months postinjury between primary and periprosthetic distal femur fractures in older adults. METHODS A registry-based cohort study was conducted including all adults 70 years of age or older registered by the Victorian Orthopaedic Trauma Outcomes Registry who experienced a primary or periprosthetic distal femur fracture between 2007 and 2017. Outcomes included mortality and health status (Three-Level European Quality of Life-Five Dimensions Scale [EQ-5D-3L]) collected at 6 and 12 months postinjury. All distal femur fractures were confirmed by radiological review. Multivariable logistic regression was conducted to report associations between fracture type and mortality and health status. RESULTS A final cohort of 292 participants was identified. Overall mortality for the cohort was 29.8%, and no significant differences were found in mortality rate or EQ-5D-3L outcomes between fracture types (ie, primary vs. periprosthetic). A large proportion of participants reported problems across all EQ-5D-3L domains at 6 and 12 months postinjury, with slightly worse outcomes in the primary fracture group. CONCLUSIONS This study reports high mortality and poor 12-month outcomes in an older adult cohort with both periprosthetic and primary distal femur fractures. Given these poor outcomes, fracture prevention and a greater focus on long-term rehabilitation is needed in this cohort. In addition, the involvement of an ortho-geriatrician should be considered as a routine component of care. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- Anne M Mather
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Elton Edwards
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
| | - Raphael Hau
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC, Australia; and
| | - Christina L Ekegren
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| |
Collapse
|
3
|
Takegami Y, Osawa Y, Iida H, Okamoto M, Ozawa Y, Funahashi H, Ido H, Asamoto T, Imagama S. Addressing osteoporosis treatment after hemiarthroplasty for a femoral neck fracture: impact on survival rates after a subsequent periprosthetic femoral fracture - a multicenter (TRON group) retrospective study. Arch Osteoporos 2023; 18:122. [PMID: 37726555 DOI: 10.1007/s11657-023-01330-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023]
Abstract
This study investigated the impact of osteoporosis treatment on the prognosis of patients with periprosthetic femoral fracture (PPF) following femoral neck fracture (FNF). Our results suggested an association between osteoporosis treatment and potentially improved survival prognosis in patients who underwent surgery for PPF. These results imply that osteoporosis treatment may have a beneficial effect on patient outcomes. PURPOSE This study aimed to investigate the effect of osteoporosis treatment on the prognosis of periprosthetic femoral fracture (PPF) patients after femoral neck fracture. METHODS A multicenter retrospective study named as TRON was conducted. The study population included 156 PPF patients who had undergone hemiarthroplasty for femoral neck fracture between January 2010 and December 2019. Patients were divided based on whether they had received osteoporosis treatment before PPF injury. A log-rank test was used to compare survival rates. We conducted a Cox proportional hazards analysis to identify factors associated with the survival rate after PFF injury. RESULTS Twenty-seven of the 156 patients had received osteoporosis treatment prior to PPF injury. The 1-year and 2-year overall survival rates after PPF were 80.9% and 75.3%, respectively. The log-rank test revealed that the 1-year survival rate with and without osteoporosis treatment was 89.5% and 78.1%, respectively (P=0.012). In the Cox proportional hazards analysis, age, BMI, presence or absence of surgery, and presence or absence of osteoporosis treatment showed independent associations with the survival rate after PFF injury. The hazard ratio for the presence of osteoporosis treatment was 0.22 (95% confidence interval 0.07-0.75, P=0.015). CONCLUSION The findings of this study suggest an association between osteoporosis treatment and potentially improved survival prognosis in patients who underwent surgery for PPF. These results imply that osteoporosis treatment may have a beneficial effect on patient outcomes. It is important to consider that osteoporosis treatment could be significant not only in preventing secondary fractures but also in potentially improving prognosis in the rare event of PPF.
Collapse
Affiliation(s)
- Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Yusuke Osawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroki Iida
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Masanori Okamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yuuto Ozawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroto Funahashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroaki Ido
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Takamune Asamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| |
Collapse
|