人工关节周围股骨骨折患者多为老年人，常被诊断为骨质疏松症。
Patients with periprosthetic femoral fractures are older adults who are commonly diagnosed with osteoporosis.
作者信息
Houel Victoria, Marchasson Gauthier, Ramdane Nassima, Philippoteaux Cécile, Paccou Julien
机构信息
Department of Rheumatology, CHU Lille, Univ. Lille, 59000, Lille, France.
Department of Biostatistics, CHU Lille, 59000, Lille, France.
出版信息
Osteoporos Int. 2025 Apr 29. doi: 10.1007/s00198-025-07486-1.
UNLABELLED
This study focused on individuals aged ≥ 50 years with periprosthetic femoral fractures (PFF). When compared to those with native hip fractures, patients with PFF were older, had a higher BMI, and demonstrated a greater number of comorbidities. Given the high frequency of osteoporosis risk factors and the BMD results, PFF should be classified as osteoporotic fractures.
INTRODUCTION
To compare patients presenting with periprosthetic femoral fractures (PFF) to patients with native hip fractures with a special focus on bone mineral density (BMD) measurements, in order to reinforce the hypothesis that PFF are osteoporotic fractures.
METHODS
A retrospective, single-centre, observational study of all patients aged ≥ 50 years with low-energy PFF identified at the Lille University Hospital from January 1, 2016, to December 31, 2022, was conducted. The PFF group was compared to a group of patients with native hip fractures hospitalized during the same period. To compare the T-score data, we used a linear mixed model that considered a predefined adjustment for age, sex, and BMI. Adjusted means ± standard error of the mean (SEM) are derived from the mixed model.
RESULTS
Among 71 patients with PFF (78.9% female, median (IQR) age 81 (72-88) years), osteoarthritis (57.8%) was the primary indication for hip surgery. Compared with the native hip fracture group (n = 117), patients in the PFF group were significantly older (p = 0.002), had a significantly greater BMI (p = 0.043), and had a higher history of multiple falls (54.3% vs. 26.1%, p < 0.001). A greater frequency of previous low-energy fractures (69.0% vs. 44.0%, p < 0.001) and an increased prescription of anti-osteoporosis medications (26.8% vs. 11.1%, p = 0.006) in patients with PFF were found. Adjusted T-scores differed between the two groups at the lumbar spine (mean adjusted ± SEM, - 0.5 ± 0.2 (PFF group) vs. - 1.2 ± 0.2 (comparator group), p = 0.008) but not at the femoral neck or at the total hip.
CONCLUSION
Low-energy PFF should be considered as an osteoporotic fracture and treated accordingly.
未标注
本研究聚焦于年龄≥50岁的人工关节周围股骨骨折（PFF）患者。与原发性髋部骨折患者相比，PFF患者年龄更大，体重指数（BMI）更高，且合并症更多。鉴于骨质疏松风险因素的高发生率及骨密度（BMD）结果，PFF应归类为骨质疏松性骨折。
引言
比较人工关节周围股骨骨折（PFF）患者与原发性髋部骨折患者，特别关注骨密度（BMD）测量结果，以强化PFF是骨质疏松性骨折这一假说。
方法
对2016年1月1日至2022年12月31日在里尔大学医院确诊的所有年龄≥50岁的低能量PFF患者进行了一项回顾性、单中心观察性研究。将PFF组与同期住院的原发性髋部骨折患者组进行比较。为比较T值数据，我们使用了线性混合模型，该模型对年龄、性别和BMI进行了预定义调整。调整后的均值±均值标准误（SEM）来自混合模型。
结果
在71例PFF患者中（78.9%为女性，中位（IQR）年龄81（72 - 88）岁），骨关节炎（57.8%）是髋关节手术的主要指征。与原发性髋部骨折组（n = 117）相比，PFF组患者年龄显著更大（p = 0.002），BMI显著更高（p = 0.043），多次跌倒史更多（54.3%对26.1%，p < 0.001）。发现PFF患者既往低能量骨折的发生率更高（69.0%对44.0%，p < 0.001），抗骨质疏松药物的处方量增加（26.8%对11.1%，p = 0.006）。两组在腰椎的调整后T值存在差异（调整后均值±SEM，-0.5±0.2（PFF组）对-1.2±0.2（对照组），p = 0.008），但在股骨颈或全髋关节处无差异。
结论
低能量PFF应被视为骨质疏松性骨折并相应进行治疗。
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