title: The influence of pre-existing radiographic osteoarthritis on functional outcome after trochanteric fracture.
abstract: OBJECTIVE
  It is crucially important to optimise functional outcome after fixation of trochanteric femoral fractures. While a number of risk factors that predict a poor clinical course have been identified, the influence of pre-existing radiographic osteoarthritis (OA) of the hip is unclear.
  
  
  METHODS
  The influence of pre-existing radiographic OA of the hip on short- to mid-term functional outcome was prospectively analysed in a cohort of patients undergoing proximal femoral nailing for trochanteric fracture. OA was graded according to Kellgren and Lawrence; functional outcome was assessed at six and 12 months by the Harris hip score (HHS), the timed up and go (TUG) test and the Barthel Index.
  
  
  RESULTS
  Our cohort comprised 188 patients (58 were male and 130 female), with a mean age of 82 years. At six and 12 months postoperatively, the HHS (p < 0.001 and p = 0.008, respectively) and Barthel Index (p < 0.001 and p = 0.02, respectively) correlated significantly with the grade of pre-existing OA. After adjustment for confounding variables, there was a significant association between the grade of pre-existing OA and the HHS at six months (p = 0.02). Although we observed trends suggestive of other relationships, none reached statistical significance.
  
  
  CONCLUSIONS
  Pre-existing radiographic OA of the hip is an important determinant of clinical outcome in elderly patients with a trochanteric femoral fracture. Further studies will be needed to establish the most effective means of restoring hip function after trochanteric femoral fracture in patients with radiographic OA of the hip.
authors: Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany.
authors: Christoph Kolja
authors: CK
authors: Boese
authors: Benjamin
authors: B
authors: Buecking
authors: Tim
authors: T
authors: Schwarting
authors: Florian
authors: F
authors: Debus
authors: Steffen
authors: S
authors: Ruchholtz
authors: Christoph
authors: C
authors: Bliemel
authors: Michael
authors: M
authors: Frink
authors: Philipp
authors: P
authors: Lechler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006620:Hip Fractures / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome