Outcome of surgical treatment of 54 Periprosthetic femoral fractures after total hip arthroplasty at mid term follow-up

Ibrahim Akkawi; Daniele Fabbri; Matteo Romantini; Massimo Laus; Alfonso Calogero

doi:10.23750/abm.v92i5.10500

Outcome of surgical treatment of 54 Periprosthetic femoral fractures after total hip arthroplasty at mid term follow-up

Authors

Ibrahim Akkawi Villa Erbosa Hospital 50/2, 40129, Bologna, Italy
Daniele Fabbri Hip Resurfacing Service, IRCCS Galeazzi Orthopaedic Institute, San Siro Clinical Institute, Milan, Italy
Matteo Romantini Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy
Massimo Laus Orthopaedics e Traumatology, Department for Special Surgery and Anesthesiology, S. Orsola-Malpighi Hospital, Via Albertoni, 15, 40138, Bologna, Italy
Alfonso Calogero Orthopaedics e Traumatology, Department for Special Surgery and Anesthesiology, S. Orsola-Malpighi Hospital, Via Albertoni, 15, 40138, Bologna, Italy

DOI: https://doi.org/10.23750/abm.v92i5.10500

Keywords:

Total hip arthroplasty ; Periprosthetic femoral fractures ; Comorbidities ; Advanced age ; Clinial Outcome ; Radiological outcome.

Abstract

Purpose: The aim of the present study was to review the outcome of the surgical treatment of 54 periprosthetic femoral fractures (PFF) after total hip arthroplasty at a mean follow-up of 45 months. At final follow-up, the clinical outcome was measured using the Harris Hip score (HHS), the Karnofsky score (KS), while, the radiographic results were evaluated using the Beals and Tower’s criteria.

Results: There were 13 post-operative complications that occurred in 10 patients with an overall re-operation rate of 11%. At final follow-up the mean HHS was 64 (range 20-100) and the mean KS was 66 (range 30-100). The radiological results were excellent in 89%, good in 9% and poor 2% of patients. The mortality rate was 0% at 3 months and 3.7% at one year post-operatively.

The mean last HHS and KS of patients older than 75 years or with comorbidities were lower than that of patients younger than 75 years or without comorbidities.

Conclusions: Although this study have shown that the surgical treatment of PFF was associated with a low re-operative rate, a good to excellent radiological results and a low mortality rate at 3 months and 1 year postoperatively, there was a marked functional deterioration in many patients. This decline of function could be attributed to the advanced age of patients and the presence of comorbidities.

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