Zhao Amy Y, Chiu Anthony, Agarwal Amil R, Harris Andrew B, Gu Alex, Kurian Shyam, Golladay Gregory J, Thakkar Savyasachi C
Department of Orthopaedic Surgery, District of Columbia, George Washington University, Washington, USA.
Department of Orthopaedic Surgery, Johns Hopkins University, 10700 Charter Drive, Columbia, Baltimore, MD, 21044, USA.
Osteoporos Int. 2025 Jun 26. doi: 10.1007/s00198-025-07583-1.
Rates of periprosthetic fracture (PPF) after total hip arthroplasty (THA) have doubled since 2010, especially among those with osteoporosis, those under the age of 50, and those with Medicaid insurance. Further work must be done to implement prevention strategies and mitigate the rise in PPF after THA in the United States.
Periprosthetic fractures (PPFs) following primary total hip arthroplasty (THA) contribute significantly to postoperative morbidity, mortality, and healthcare costs. With an aging population and increased utilization of THA in younger patients, there is potential for rates of PPF to increase accordingly. The purpose of this study was to evaluate recent trends in PPF incidence after primary THA and to identify the most affected sub-populations.
A total of 500,078 patients who underwent primary THA during the years 2010-2019 were identified in a national administrative claims database. Incidence rates of 2-year PPF and a compounded annual growth rate (CAGR) were calculated. A sub-analysis was conducted to stratify baseline characteristics including age, biological sex, and risk factors for PPF. Linear regression was performed to assess trends.
The total rate of 2-year PPF demonstrated a + 7.05% annual growth from 2010 to 2019. The most pronounced increases occurred in patients less than 50 years old (CAGR = + 9.24%, p = 0.005), with comorbid osteoporosis (CAGR = + 13.7%, p = 0.001), vitamin D deficiency (CAGR = + 12.2%, p = 0.002), and Medicaid insurance (CAGR = + 7.19%, p < 0.001).
Rates of PPF following primary THA have nearly doubled since 2010, with the greatest increases among patients with poor bone health, particularly those with osteoporosis and poor underlying bone health. These findings underscore the growing burden of osteoporosis-related complications and highlight the urgent need for improved prevention strategies, including early identification and preoperative bone health optimization.
III.
自2010年以来，全髋关节置换术（THA）后假体周围骨折（PPF）的发生率翻了一番，尤其是在骨质疏松患者、50岁以下人群以及有医疗补助保险的人群中。必须进一步开展工作，以实施预防策略并减轻美国THA后PPF发生率的上升。
初次全髋关节置换术（THA）后的假体周围骨折（PPF）对术后发病率、死亡率和医疗费用有重大影响。随着人口老龄化以及年轻患者中THA使用率的增加，PPF发生率有可能相应上升。本研究的目的是评估初次THA后PPF发生率的近期趋势，并确定受影响最大的亚人群。
在一个国家行政索赔数据库中识别出2010年至2019年期间接受初次THA的500,078例患者。计算2年PPF的发生率和复合年增长率（CAGR）。进行亚分析以对包括年龄、生物学性别和PPF危险因素在内的基线特征进行分层。进行线性回归以评估趋势。
2010年至2019年，2年PPF的总发生率显示出每年+7.05%的增长。最显著的增长发生在50岁以下的患者（CAGR = +9.24%，p = 0.005）、患有合并骨质疏松症的患者（CAGR = +13.7%，p = 0.001）、维生素D缺乏症患者（CAGR = +12.2%，p = 0.002）以及有医疗补助保险的患者（CAGR = +7.19%，p < 0.001）中。
自2010年以来，初次THA后PPF的发生率几乎翻了一番，在骨骼健康状况较差的患者中增长最为显著，尤其是那些患有骨质疏松症和潜在骨骼健康状况不佳的患者。这些发现强调了骨质疏松症相关并发症日益加重的负担，并突出了迫切需要改进预防策略，包括早期识别和术前骨骼健康优化。
III级。
