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The clinical and economic burden of proximal femur periprosthetic fractures.
- Source :
-
Musculoskeletal surgery [Musculoskelet Surg] 2022 Jun; Vol. 106 (2), pp. 201-206. Date of Electronic Publication: 2021 Feb 08. - Publication Year :
- 2022
-
Abstract
- Background: The number of hip replacements is constantly and progressively increasing, resulting in an increase in periprosthetic fractures. The main aim of this study is to analyze costs and outcomes of surgical treatment for those fractures.<br />Materials and Methods: A retrospective study was performed on periprosthetic proximal femur fracture presented a single-level I trauma center. Medical records were reviewed in terms of demographic data, diagnosis (according to Vancouver classification), type of surgical treatment, hospitalization length and follow-up. Patients were interviewed about number of consultations after discharge, medications and physiotherapy sessions. Clinical outcome was evaluated with WOMAC score at the last follow-up, and patient health status was evaluated with the EQ5D5L score pre-trauma and at the last follow-up. Patients were divided into two groups according to surgical treatment: reduction and internal fixation alone and revision plus fixation. A further group was also considered: patients underwent a Girdlestone procedure. Global costs for each group were calculated.<br />Results: We initially recruited 117 patients, 17 of them were lost at follow-up. Furthermore, 19 patients (19%) died during the follow-up, and 81 of them were therefore included in the study. Mean follow-up was 26.5 months. Mean postoperative WOMAC score was 39.44, and EQ5D5L score was 9.12 for the preoperative period and 12.35 at the last follow-up. A significant worsening of clinical conditions was found comparing the period before fracture to the last follow-up (p < 0.01). Quality of life after surgery resulted to be poor or fair in 40% of the patients at a mean follow-up of 26.5 months. No significant differences between groups were found according to patients' health status. Mean global costs for mayor surgeries were 18,822 Euros; mean costs for fixation alone were 17,298 Euros while for fixation and revision were 20,966 Euros, but no statistically difference was found between these two groups. Mean cost for Girdlestone group was 12,664 Euros.<br />Conclusions: In proximal femur periprosthetic fractures, either fixation or revision plus fixation presents high costs but patients' postoperative quality of life is poor.<br /> (© 2021. Istituto Ortopedico Rizzoli.)
- Subjects :
- Femur surgery
Financial Stress
Fracture Fixation, Internal economics
Fracture Fixation, Internal methods
Fracture Fixation, Internal standards
Humans
Medical Records
Quality of Life
Reoperation methods
Retrospective Studies
Treatment Outcome
Arthroplasty, Replacement, Hip methods
Femoral Fractures economics
Femoral Fractures etiology
Femoral Fractures surgery
Periprosthetic Fractures economics
Periprosthetic Fractures etiology
Periprosthetic Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2035-5114
- Volume :
- 106
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Musculoskeletal surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33555554
- Full Text :
- https://doi.org/10.1007/s12306-020-00694-4