The Effect of Periprosthetic Fractures Following Total Hip and Knee Arthroplasty on Long-Term Functional Outcomes and Quality of Life

Andrew Luzzi, MD; Akshay Lakra, MD; Taylor Murtaugh, MD; Roshan P. Shah, MD, JD; H. John Cooper, MD; Jeffrey A. Geller, MD

Arthroplasty Today (Oct 2024)

The Effect of Periprosthetic Fractures Following Total Hip and Knee Arthroplasty on Long-Term Functional Outcomes and Quality of Life

Andrew Luzzi, MD,
Akshay Lakra, MD,
Taylor Murtaugh, MD,
Roshan P. Shah, MD, JD,
H. John Cooper, MD,
Jeffrey A. Geller, MD

Affiliations

Andrew Luzzi, MD: Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
Akshay Lakra, MD: Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
Taylor Murtaugh, MD: Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
Roshan P. Shah, MD, JD: Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
H. John Cooper, MD: Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
Jeffrey A. Geller, MD: Corresponding author. Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 W. 168th Street, PB-1155, New York, NY 10032, USA. Tel.: +1 212 305 1120.; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA

Journal volume & issue: Vol. 29
p. 101418

Abstract

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Background: Periprosthetic fractures (PPFs) after total joint arthroplasty (TJA) can be devastating, yet their long-term impact has not been well described. The aim of this study is to compare the long-term outcomes of patients who sustained a PPF about a TJA with those of patients who underwent an uncomplicated TJA. Methods: Patients who sustained a PPF after primary TJA between 2005 and 2014 were identified. Seventeen patients with a minimum 2-year follow-up (PPF cohort) were compared to a matched cohort of 67 patients who underwent uncomplicated TJA. Demographic data, comorbidities, surgical details, and complications were analyzed. Quality of life and functional outcomes were assessed with 12-Item Short Form Health Survey (SF-12), Western Ontario and McMasdter Universities Arthritis Index (WOMAC), and Knee Society Function Score. Results: The overall complication rate was 41.2% in the PPF group, including 3 additional fractures (17.6%), 2 wound infections (11.8%), one prosthetic joint infection (5.8%), and one painful patellar hardware necessitating removal (5.8%). At 2 years, both physical and mental components of the SF-12 were significantly lower for the PPF cohort vs control (SF-12-P, 28.7 ± 4.4 vs 40.8 ± 10.3, P < .001, SF-12-M, 36.7 ± 5.07 vs 55.0 ± 8.19, P < .0001). WOMAC pain and function scores were also significantly worse in the PPF cohort vs control at 2 years (WOMAC-pain, 38.8 ± 29.9 vs 87.4 ± 22.1; P < .0001, WOMAC-function, 40.7 ± 8.7 vs 76.1 ± 20.3; P < .0001). At 2 years, score improvements from prearthroplasty baseline were significantly greater in the control cohort vs PPF for SF-12-physical, WOMAC-pain, and WOMAC-function. Conclusions: Patients who sustained PPFs following TJA have poor long-term outcomes despite appropriate treatment. These results can help counsel patients and encourage heightened efforts to minimize the risk of PPF. Level of Evidence: Level III.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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