title: Are gender, comorbidity, and obesity risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty?
abstract: We studied the frequency and patient risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty (THA). With a mean follow-up of 6.3 years, 305 postoperative periprosthetic fractures occurred in 14,065 primary THAs. In multivariable-adjusted Cox regression analyses, female gender (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.17-1.88), Deyo-Charlson comorbidity score of 2 (HR, 1.74 for score of 2; 95% CI, 1.25-2.43) or 3 or higher (HR, 1.71; 95% CI, 1.26-2.32), and American Society of Anesthesiologist class of 2 (HR, 1.84; 95% CI, 0.90-3.76) or 3 (HR, 2.45; 95% CI, 1.18-5.1) or 4 or higher (HR, 2.68; 95% CI, 0.70-10.28) were significantly associated with higher risk/hazard, and cemented implant, with lower hazard (HR, 0.68; 95% CI, 0.54-0.87) of postoperative periprosthetic fractures. Interventions targeted at optimizing comorbidity management may decrease postoperative fractures after THA.
authors.affiliation: Medicine Service and Center for Surgical Medical Acute Care Research and Transitions (CSMART), Birmingham VA Medical Center, Birmingham, Alabama 35294, USA.
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Jensen
authors.forename: Scott W
authors.initials: SW
authors.lastname: Harmsen
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002484:Cementation; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D057068:Periprosthetic Fractures / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors