{"title":"Predictive factors for reoperation after periprosthetic femoral fracture: A retrospective multicenter (TRON) study","authors":"Manato Iwata , Yasuhiko Takegami , Katsuhiro Tokutake , Hiroshi Kurokawa , Hideomi Takami , Satoshi Terasawa , Tetsuro Takatsu , Shiro Imagama","doi":"10.1016/j.jos.2023.11.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div><span>The surgical treatment of periprosthetic femoral fracture (PFF) can be technically demanding and it is associated with high rates of complications and repeat surgery. However, repeat surgery is uncommon and few studies have examined survival and the functional prognosis following </span>reoperation<span> after the surgical treatment of PFF. We aimed to estimate the rate of reoperation for any reason, to determine the survival rate after reoperation for PFF, and to identify predictors associated with reoperation after PFF surgery in a multicenter (TRON group) study.</span></div></div><div><h3>Methods</h3><div>Two hundred forty-six patients were admitted for treatment of PFF. After excluding patients managed conservatively and those with Vancouver type A fracture, we analyzed 184 patients. Unadjusted risk ratios (RRs) were calculated, and multiple logistic regression was used to calculate adjusted RRs. We used the Kaplan-Meier method to create survival curves and a log-rank test to determine survival from the date of repeat surgery.</div></div><div><h3>Results</h3><div>Fifteen of the 184 patients (8.2 %) underwent reoperation after PFF surgery. The 1-year survival rate after reoperation for PFF was 66.7 % (11 of 15). Vancouver B3 and Vancouver C were identified as independent risk factors for reoperation after PFF surgery (Vancouver B3: Risk ratio [RR] 19.0, 95 % CI 1.10–329 P < 0.001; Vancouver C: RR 13.3, 95 % CI 1.4–123.0, P = 0.023).</div></div><div><h3>Conclusion</h3><div>The reoperation rate after PFF surgery and the mortality after reoperation PFF surgery were relatively high. The fracture type is associated with reoperation after PFF surgery.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1445-1450"},"PeriodicalIF":1.5000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0949265823003305","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The surgical treatment of periprosthetic femoral fracture (PFF) can be technically demanding and it is associated with high rates of complications and repeat surgery. However, repeat surgery is uncommon and few studies have examined survival and the functional prognosis following reoperation after the surgical treatment of PFF. We aimed to estimate the rate of reoperation for any reason, to determine the survival rate after reoperation for PFF, and to identify predictors associated with reoperation after PFF surgery in a multicenter (TRON group) study.
Methods
Two hundred forty-six patients were admitted for treatment of PFF. After excluding patients managed conservatively and those with Vancouver type A fracture, we analyzed 184 patients. Unadjusted risk ratios (RRs) were calculated, and multiple logistic regression was used to calculate adjusted RRs. We used the Kaplan-Meier method to create survival curves and a log-rank test to determine survival from the date of repeat surgery.
Results
Fifteen of the 184 patients (8.2 %) underwent reoperation after PFF surgery. The 1-year survival rate after reoperation for PFF was 66.7 % (11 of 15). Vancouver B3 and Vancouver C were identified as independent risk factors for reoperation after PFF surgery (Vancouver B3: Risk ratio [RR] 19.0, 95 % CI 1.10–329 P < 0.001; Vancouver C: RR 13.3, 95 % CI 1.4–123.0, P = 0.023).
Conclusion
The reoperation rate after PFF surgery and the mortality after reoperation PFF surgery were relatively high. The fracture type is associated with reoperation after PFF surgery.
期刊介绍:
The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.