Evidence map›Paper›PMID 29926148›Full record

Observational studyInternational orthopaedics2019

Osteoarthritis is associated with increased failure of proximal femoral fracture fixation.

Charles A Gallagher, Christopher W Jones, Lara Kimmel, Christopher Wylde, Anthony Osbrough, Max Bulsara, Kathryn Hird, Piers Yates

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. [Femoral neck fractures].Orthopadie (Heidelberg, Germany) · 2023
    Article
  4. Article
  5. Article
  6. Review
  7. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Charles A GallagherDepartment of Orthopaedics, Fremantle Hospital, Alma Street, Fremantle, WA, 6160, Australia. gallaghercharles@hotmail.com.ORCID 0000-0003-1550-2524
Christopher W JonesDepartment of Orthopaedics, Fremantle Hospital, Alma Street, Fremantle, WA, 6160, Australia.
Lara KimmelDepartment of Physiotherapy, The Alfred Hospital, Melbourne, VIC, Australia.
Christopher WyldeDepartment of Orthopaedics, Fremantle Hospital, Alma Street, Fremantle, WA, 6160, Australia.
Anthony OsbroughDepartment of Orthopaedics, Fremantle Hospital, Alma Street, Fremantle, WA, 6160, Australia.
Max BulsaraInstitute of Health Research, University of Notre Dame, Fremantle, WA, Australia.
Kathryn HirdSchool of Medicine, University of Notre Dame, Fremantle, WA, Australia.
Piers YatesDepartment of Orthopaedics, Fremantle Hospital, Alma Street, Fremantle, WA, 6160, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to evaluate whether the presence of hip osteoarthritis at the time of hip fracture increases treatment failure rates when using either a sliding hip screw (SHS) or proximal femoral nail (PFN) for fracture fixation.

methodsA retrospective study of a consecutive series of 455 women and 148 men (median age, 83.8 years) treated with SHS or PFN was performed. Osteoarthritis was evaluated based on pre-operative radiographs using the Kellgren and Lawrence grading system. Treatment failure, which was defined as non-union, avascular necrosis, backing out of the implant, cut out of the proximal screws, peri-prosthetic fracture, implant breakage, or conversion to hemi- or total hip arthroplasty, was evaluated for a follow-up period of four to seven years. Optimal placement of the implant (tip-apex distance (TAD) and 3-point fixation) and the effects of age, sex, the quality of reduction, implant type, fracture stability, fracture type, and time to failure were considered confounders of the relationship between failure and osteoarthritis (OA).

resultsAmong the 32 cases (5.3%) of treatment failure, 12 (2%) showed evidence of osteoarthritis. After controlling for age, sex, the quality of reduction, implant type, fracture stability, fracture type, and TAD, osteoarthritis was associated a greater than threefold increase in treatment failure compared with that of patients without pre-operative evidence of osteoarthritis (OR, 3.26; 95% CI, 1.4-7.65; P = 0.006).

conclusionsAfter adjusting for potential confounding factors, radiographic evidence of hip osteoarthritis at the time of hip fracture increases the incidence of treatment failure.

Indexed as

AgedAged, 80 and overBone NailsBone ScrewsFemaleFracture Fixation, InternalFracture Fixation, IntramedullaryFracture HealingHip FracturesHumansMaleOsteoarthritis, HipRetrospective StudiesTreatment FailureFailureFractureHipNeck of femurOsteoarthritisTreatment

Identifiers

PMID29926148

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.