Survivorship After Periprosthetic Femur Fracture: Factors Affecting Outcome

J Arthroplasty. 2016 Jun;31(6):1283-1288. doi: 10.1016/j.arth.2015.11.038. Epub 2015 Dec 9.


Background: 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.

Methods: A retrospective review was performed for 291 patients treated surgically for PPFx between 2004 and 2013. Primary outcomes were death and reoperation.

Results: 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.

Conclusion: 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.

Keywords: mortality; periprosthetic fracture; revision total hip arthroplasty; revision total knee arthroplasty; total hip arthroplasty; total knee arthroplasty.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects
  • Female
  • Femoral Fractures / surgery*
  • Femur / surgery*
  • Fracture Fixation, Internal / adverse effects*
  • Histological Techniques
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Periprosthetic Fractures / surgery*
  • Proportional Hazards Models
  • Reoperation / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Time Factors
  • Treatment Outcome