title: Survivorship After Periprosthetic Femur Fracture: Factors Affecting Outcome.
abstract: Data addressing risk factors predictive of mortality and reoperation after periprosthetic femur fractures (PPFxs) are lacking. This study examined survivorship and risk ratios for mortality and reoperation after surgical treatment for PPFx and associated clinical risk factors.
  
  
  
  A retrospective review was performed for 291 patients treated surgically for PPFx between 2004 and 2013. Primary outcomes were death and reoperation.
  
  
  
  Mortality at 1 year was 13%, whereas the rate of reoperation was 12%. Greater span of fixation and revision arthroplasty (vs open reduction internal fixation) trended toward a lower likelihood of reoperation.
  
  
  
  After PPFx, patients have a 24% risk of either death or reoperation at 1 year. Factors contributing to increased mortality are nonmodifiable. Risk of reoperation is minimized with greater span of fixation and performance of revision arthroplasty.
authors.affiliation: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina; Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Drew
authors.affiliation: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.
authors.forename: William L
authors.initials: WL
authors.lastname: Griffin
authors.affiliation: OrthoCarolina Research Institute, Charlotte, North Carolina.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Odum
authors.affiliation: OrthoCarolina Research Institute, Charlotte, North Carolina.
authors.forename: Bryce
authors.initials: B
authors.lastname: Van Doren
authors.affiliation: OrthoCarolina Research Institute, Charlotte, North Carolina.
authors.forename: Brock T
authors.initials: BT
authors.lastname: Weston
authors.affiliation: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina; Department of Orthopaedics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Stryker
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006652:Histological Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057068:Periprosthetic Fractures / Q000601:surgery*; D016016:Proportional Hazards Models; D012086:Reoperation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: mortality; periprosthetic fracture; revision total hip arthroplasty; revision total knee arthroplasty; total hip arthroplasty; total knee arthroplasty