title: Incidence and Future Projections of Periprosthetic Femoral Fracture Following Primary Total Hip Arthroplasty: An Analysis of International Registry Data.
abstract: As the number of total hip arthroplasties (THA) increases, the number of fractures will increase as well. The purpose of this study was to determine the incidence and prevalence of intra- and post-operative periprosthetic fractures following THA based on national joint registry data and to create a projection model that estimates the future fracture burden. Registry data from multiple joint registries were analyzed. Data on the incidence and prevalence of intra- and post-operative periprosthetic fractures were extracted. The prevalences between individual countries were analyzed to determine the mean prevalence. Three quantitative models were then generated to predict the fracture burden in the United States based on future population trends between 2015 and 2060. The mean incidence of post-operative periprosthetic fractures requiring revision was 0.8% while the incidence of intraoperative fractures was 0.8%. When all revision arthroplasties were assessed, the mean proportion of hips revised due to periprosthetic fracture was 6.6%. Projection models demonstrated that the number of periprosthetic fractures is expected to rise by a mean 4.6% every decade over the next 30 years. Periprosthetic fractures represent a small but important proportion of the revision THA burden worldwide. The incidence of both intra- and post-operative fractures is low, but the number is likely to steadily increase along with the number of surgeries performed. The number of fractures may rise even further as the incidence may potentially be higher in elderly, osteoporotic patients who are likely to represent a greater proportion of the arthroplasty population, particularly.
authors: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Robert
authors: R
authors: Pivec
authors: Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ; Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Kimona
authors: K
authors: Issa
authors: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland; Family Orthopaedic Center, St. Margaret's Hospital, Spring Valley, Illinois.
authors: Bhaveen H
authors: BH
authors: Kapadia
authors: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Jeffery J
authors: JJ
authors: Cherian
authors: Department of Orthopaedics and Rehabilitation, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 30, Brooklyn, New York 11203; Department of Orthopedic Oncology, Washington Hospital Center, 110 Irving Street, Washington DC 20010.
authors: Aditya V
authors: AV
authors: Maheshwari
authors: Bonutti Clinic, Effingham, Illinois.
authors: Peter M
authors: PM
authors: Bonutti
authors: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors: Michael A
authors: MA
authors: Mont
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005264:Femoral Fractures / Q000453:epidemiology* / Q000209:etiology; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D057068:Periprosthetic Fractures / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications; D015995:Prevalence; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D014481:United States