Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Arch Osteoporos. 2023 Sep 20;18(1):122. doi: 10.1007/s11657-023-01330-x.
This study investigated the impact of osteoporosis treatment on the prognosis of patients with periprosthetic femoral fracture (PPF) following femoral neck fracture (FNF). Our results suggested an association between osteoporosis treatment and potentially improved survival prognosis in patients who underwent surgery for PPF. These results imply that osteoporosis treatment may have a beneficial effect on patient outcomes.
This study aimed to investigate the effect of osteoporosis treatment on the prognosis of periprosthetic femoral fracture (PPF) patients after femoral neck fracture.
A multicenter retrospective study named as TRON was conducted. The study population included 156 PPF patients who had undergone hemiarthroplasty for femoral neck fracture between January 2010 and December 2019. Patients were divided based on whether they had received osteoporosis treatment before PPF injury. A log-rank test was used to compare survival rates. We conducted a Cox proportional hazards analysis to identify factors associated with the survival rate after PFF injury.
Twenty-seven of the 156 patients had received osteoporosis treatment prior to PPF injury. The 1-year and 2-year overall survival rates after PPF were 80.9% and 75.3%, respectively. The log-rank test revealed that the 1-year survival rate with and without osteoporosis treatment was 89.5% and 78.1%, respectively (P=0.012). In the Cox proportional hazards analysis, age, BMI, presence or absence of surgery, and presence or absence of osteoporosis treatment showed independent associations with the survival rate after PFF injury. The hazard ratio for the presence of osteoporosis treatment was 0.22 (95% confidence interval 0.07-0.75, P=0.015).
The findings of this study suggest an association between osteoporosis treatment and potentially improved survival prognosis in patients who underwent surgery for PPF. These results imply that osteoporosis treatment may have a beneficial effect on patient outcomes. It is important to consider that osteoporosis treatment could be significant not only in preventing secondary fractures but also in potentially improving prognosis in the rare event of PPF.
本研究旨在探讨骨质疏松症治疗对股骨颈骨折（FNF）后股骨假体周围骨折（PPF）患者预后的影响。
进行了一项名为 TRON 的多中心回顾性研究。研究人群包括 156 例股骨颈骨折行人工半髋关节置换术的 PPF 患者，这些患者均于 2010 年 1 月至 2019 年 12 月接受治疗。根据患者是否在 PPF 损伤前接受骨质疏松症治疗，将其分为两组。采用对数秩检验比较生存率。我们进行了 Cox 比例风险分析，以确定与 FNF 损伤后生存率相关的因素。
在 156 例患者中，有 27 例在 PPF 损伤前接受了骨质疏松症治疗。PPF 后 1 年和 2 年的总生存率分别为 80.9%和 75.3%。对数秩检验显示，有和无骨质疏松症治疗的 1 年生存率分别为 89.5%和 78.1%（P=0.012）。在 Cox 比例风险分析中，年龄、BMI、是否手术以及是否接受骨质疏松症治疗与 FNF 损伤后生存率独立相关。骨质疏松症治疗的存在与生存率呈负相关，其风险比为 0.22（95%置信区间 0.07-0.75，P=0.015）。
本研究结果提示，骨质疏松症治疗与接受 PPF 手术的患者的生存预后改善之间存在关联。这些结果表明，骨质疏松症治疗可能对患者的结局产生有益影响。考虑到骨质疏松症治疗不仅在预防继发性骨折方面具有重要意义，而且在罕见的 PPF 情况下也可能改善预后，这一点很重要。
