Bone Joint J. 2022 Aug;104-B(8):987-996. doi: 10.1302/0301-620X.104B8.BJJ-2021-1681.R1.
The aim of this study was to describe the demographic details of patients who sustain a femoral periprosthetic fracture (PPF), the epidemiology of PPFs, PPF characteristics, and the predictors of PPF types in the UK population.
This is a multicentre retrospective cohort study including adult patients presenting to hospital with a new PPF between 1 January 2018 and 31 December 2018. Data collected included: patient characteristics, comorbidities, anticoagulant use, social circumstances, level of mobility, fracture characteristics, Unified Classification System (UCS) type, and details of the original implant. Descriptive analysis by fracture location was performed, and predictors of PPF type were assessed using mixed-effects logistic regression models.
In total, 720 femoral PPFs from 27 NHS sites were included. PPF patients were typically elderly (mean 79.9 years (SD 10.6)), female (n = 455; 63.2%), had at least one comorbidity (n = 670; 93.1%), and were reliant on walking aids or bed-/chair-bound prior to admission (n = 419; 61.7%). The study population included 539 (74.9%) hip PPFs, 151 (21.0%) knee PPFs, and 30 (4.2%) dividing type PPFs. For hip (n = 407; 75.5%) and knee (n = 88; 58.3%) arthroplasty UCS B type fractures were most common. Overall, 556 (86.2%) were treated in the presenting hospital and 89 (13.8%) required transfer for treatment. Female sex was the only significant predictor of fracture type (A/B1/C type versus B2/B3) for femoral hip PPFs (odds ratio 0.61 (95% confidence interval 0.41 to 0.91); p = 0.014). Sex, residence type, primary versus revision implant PPF, implant fixation, and time between arthroplasty and PPF were not found to predict fracture type for hip PPFs.
This multicentre analysis describes patient and injury factors for patients presenting with femoral PPFs to centres across the UK. These patients are generally elderly and frail, comparable to those sustaining a hip fracture. These data can be useful in planning future services and clinical trials. Cite this article: 2022;104-B(8):987-996 .
本研究旨在描述发生股骨假体周围骨折（PPF）患者的人口统计学细节、PPF 的流行病学、PPF 特征以及英国人群中 PPF 类型的预测因素。
这是一项多中心回顾性队列研究，纳入 2018 年 1 月 1 日至 2018 年 12 月 31 日期间因新发 PPF 就诊于医院的成年患者。收集的数据包括：患者特征、合并症、抗凝药物使用、社会环境、活动水平、骨折特征、统一分类系统（UCS）类型以及原始植入物的详细信息。按骨折部位进行描述性分析，并使用混合效应逻辑回归模型评估 PPF 类型的预测因素。
共纳入来自 27 个 NHS 站点的 720 例股骨 PPF。PPF 患者通常为老年人（平均 79.9 岁（10.6 岁））、女性（n = 455；63.2%）、至少有一种合并症（n = 670；93.1%），且在入院前依赖助行器或卧床/轮椅（n = 419；61.7%）。研究人群包括 539 例（74.9%）髋关节 PPF、151 例（21.0%）膝关节 PPF 和 30 例（4.2%）分界型 PPF。对于髋关节（n = 407；75.5%）和膝关节（n = 88；58.3%）关节置换术，UCS B 型骨折最为常见。总体而言，556 例（86.2%）在就诊医院接受治疗，89 例（13.8%）需要转院治疗。女性是股骨髋关节 PPF 骨折类型（A/B1/C 型与 B2/B3 型）的唯一显著预测因素（比值比 0.61（95%置信区间 0.41 至 0.91）；p = 0.014）。性别、居住类型、初次与翻修植入物 PPF、植入物固定以及关节置换与 PPF 之间的时间均未发现与髋关节 PPF 骨折类型相关。
这项多中心分析描述了英国各地中心就诊的股骨 PPF 患者的患者和损伤因素。这些患者通常为老年人，身体虚弱，与髋部骨折患者相似。这些数据可用于规划未来的服务和临床试验。引用本文：2022；104-B（8）：987-996.
