Increased risk of postoperative periprosthetic fracture in patients with total hip or knee arthroplasties

Assessing for fracture risk in older patients who have undergone total hip and knee arthroplasties can be successfully completed using FRAX.

Postoperative periprosthetic fractures (PPF) are severe complications of total hip or knee arthroplasties (THA/TKA) and are associated with an important burden for patients as well as high costs for the health care system.

A study conducted in Austria evaluated the value of FRAX to estimate the risk of postoperative periprosthetic fractures in 167 patients following total hip and knee arthroplasty. For all patients, the 10-year probability of a major osteoporotic fracture and an osteoporotic hip fracture was calculated using FRAX.

The results of the study showed that the majority of patients with a postoperative periprosthetic fracture had an increased risk (10-year probability) of major osteoporotic fracture and hip fracture according to FRAX. Despite this high risk though, less than 10% of the patients received adequate anti-osteoporotic treatment.

Moreover, a significant correlation was found between the 10-year probability of a major osteoporotic fracture and hip fracture and postoperative periprosthetic fractures in THA and TKA, indicating that FRAX might be a useful tool in calculating fracture risk in these patients. The risk of PPF was also higher in older patients and patients who had sustained a previous fracture.

The study highlights, among other findings, the serious undertreatment of patients with PPF in respect to osteoporosis, an issue of major importance that must be managed by a multidisciplinary team.

Read the study here!