Secondary total hip arthroplasty common in elderly with internally fixated acetabular fractures
Canada: Compared to younger patients, older patients with an AF open reduction internal fixation are at significantly higher risk for secondary total hip arthroplasty (THA), finds a recent study in the Journal of Arthroplasty.
Geriatric patients are the most rapidly growing patient cohort sustaining acetabular fractures (AFs). Graeme Hoit, University of Toronto, Toronto, ON, Canada, and colleagues aimed to examine the risk of secondary THA older patients aged 60 years and above with a prior AF open reduction internal fixation (ORIF) compared to younger patients (<60 years old) with an AF ORIF on a large population level.
For the purpose, the researchers identified and included all adults patients with an AF ORIF and a minimum of two years follow-up using administrative healthcare data from 1996-2010 inclusive of all 202 hospital in Ontario, Canada. THA risk was examined using a Cox proportional hazards model adjusting for patient risk factors. Secondary outcomes included surgical complications and all-cause mortality.
The study overall included a total of 1,725 patients having an AF ORIF; 1,452 (84.2%) aged <60 years ("younger") and 273 (15.8%) >60 years ("older"). They were followed for a median of 6.9 years.
Key findings of the study include:
- In older patients, 19.4% went on to receive a secondary THA with a median time to event of 3.9 years, compared to 12.9% in the younger patient cohort with a median time of 6.9 years (HR 1.7).
- As expected, older patients had a higher 90-day mortality rate compared to younger patients (7.7% vs 0.7%, respectively; HR 9.2).
"Older patients with an AF ORIF are at a significantly higher risk for a secondary THA compared to younger patients with an AF ORIF," wrote the authors.
The study tiled, "Risk of Total Hip Arthroplasty after Acetabular Fracture Fixation: The Importance of Age," is published in the Journal of Arthroplasty.