Patient-reported outcomes following operatively managed periprosthetic femoral fractures around Exeter polished taper slip femoral components

Matilda F R Powell-Bowns; Jonathan T Super; Damien H Martin; Kirsty Milne; Nick D Clement; Chloe E H Scott

doi:10.1302/2633-1462.72.BJO-2025-0129.R2

Patient-reported outcomes following operatively managed periprosthetic femoral fractures around Exeter polished taper slip femoral components

Bone Jt Open. 2026 Feb 25;7(2):275-282. doi: 10.1302/2633-1462.72.BJO-2025-0129.R2.

Authors

Matilda F R Powell-Bowns¹, Jonathan T Super², Damien H Martin², Kirsty Milne², Nick D Clement^{2

3}, Chloe E H Scott^{2

4}

Affiliations

¹ Southmead Hospital, Bristol, UK.
² Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
³ University of Edinburgh, Edinburgh, UK.
⁴ Mechanical Engineering, Imperial College, London, UK.

PMID: 41736524
PMCID: PMC12933207
DOI: 10.1302/2633-1462.72.BJO-2025-0129.R2

Abstract

Aims: Periprosthetic femoral fractures (PFFs) have emerged as the leading cause of reoperation following total hip arthroplasty (THA). This study aimed to evaluate patient-reported outcomes following operative management of PFFs with either fixation or revision arthroplasty around Exeter femoral components.

Methods: From a trauma database, 112 patients with operatively managed postoperative PFFs involving Exeter femoral componentss were identified from 2017 to 2023 (minimum one year follow-up). Patients who responded (89/112, 79%: mean age 73.3 years (SD 10.1; 44 to 92; 35/89 female) completed validated patient-reported outcome measures (PROMs), including the EuroQol five-dimension three-level questionnaire (EQ-5D-3L), Oxford Hip Score (OHS), and Lower Extremity Functional Scale (LEFS), to assess both recalled prefracture and follow-up status.

Results: Fractures had been treated with fixation in 65/89 (73%) or revision THA (RTHA) in 24/89 (27%). There were no differences in patient demographic details between fixation and RTHA groups. Compared to recalled prefracture status, patients displayed significant postoperative declines across all PROMs (p < 0.001). The median EQ-5D declined by 0.106 following fixation and by 0.204 following RTHA, with no difference between groups (p = 0.500). Median OHS and LEFs declined by 3 and 2.5 points, respectively, in patients treated with fixation and by 5 and 8 points after RTHA. Overall, clinically meaningful declines in OHS of > 8 points were experienced by 34.8% (31/89) of patients and 62% of patients expressed satisfaction, with no significant differences between operative strategies (p = 0.621).

Conclusion: Health-related quality of life and joint-specific function declined significantly following Exeter femoral component associated postoperative periprosthetic fractures with comparable outcomes following RTHA or fixation of appropriately selected cases. Despite functional declines, most patients were satisfied with their outcome.