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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2015012625
pages 269-275

Incidence and Future Projections of Periprosthetic Femoral Fracture Following Primary Total Hip Arthroplasty: An Analysis of International Registry Data

Robert Pivec
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Kimona Issa
School of Health and Medical Sciences, Department of Orthopaedics, Seton Hall University, 400 S Orange Ave, South Orange, New Jersey
Bhaveen V. Kapadia
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Jeffery J. Cherian
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
Aditya V. Maheshwari
Division of Adult Reconstruction, SUNY Downstate Medical Center, Brooklyn, New York; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York
Peter M. Bonutti
Bonutti Clinic, Effingham, Illinois
Michael A. Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland

ABSTRACT

As the number of total hip arthroplasties (THA) increases, the number of fractures will increase as well. The purpose of this study was to determine the incidence and prevalence of intra- and post-operative periprosthetic fractures following THA based on national joint registry data and to create a projection model that estimates the future fracture burden. Registry data from multiple joint registries were analyzed. Data on the incidence and prevalence of intra- and post-operative periprosthetic fractures were extracted. The prevalences between individual countries were analyzed to determine the mean prevalence. Three quantitative models were then generated to predict the fracture burden in the United States based on future population trends between 2015 and 2060. The mean incidence of post-operative periprosthetic fractures requiring revision was 0.8% while the incidence of intraoperative fractures was 0.8%. When all revision arthroplasties were assessed, the mean proportion of hips revised due to periprosthetic fracture was 6.6%. Projection models demonstrated that the number of periprosthetic fractures is expected to rise by a mean 4.6% every decade over the next 30 years. Periprosthetic fractures represent a small but important proportion of the revision THA burden worldwide. The incidence of both intra- and post-operative fractures is low, but the number is likely to steadily increase along with the number of surgeries performed. The number of fractures may rise even further as the incidence may potentially be higher in elderly, osteoporotic patients who are likely to represent a greater proportion of the arthroplasty population, particularly.