SynthesisArchives of orthopaedic and trauma surgery2021
Does early surgery improve outcomes for periprosthetic fractures of the hip and knee? A systematic review and meta-analysis.
Synthesis in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Association between timing of surgery and postoperative outcomes in older adults with distal femur fractures: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Spinal Dexamethasone Effect on Cognitive Disorders After Hip Surgery.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2023Trial
- Operative treatment is associated with improved 3-year survival after periprosthetic humerus fracture.JSES international · 2026Article
- Quality of Life Following Vancouver Type B Periprosthetic Femoral Fractures: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2025Article
- Outcomes of revisions and fixations following periprosthetic fractures around the hip: a retrospective service evaluation.Journal of clinical orthopaedics and trauma · 2025Article
- Article
- Open reduction, internal fixation of Vancouver B1, C & D type periprosthetic femoral fractures with use of an antiglide plate at fracture apex - The "Apex Plate".Trauma case reports · 2025Article
- The incidence and risk factors of phobic movement disorder after hip fracture internal fixation surgery.Journal of orthopaedic surgery and research · 2025Article
- Clinical and Functional Outcomes of Peri-Implant Fractures Associated with Short Proximal Femur Nails: Prevention Strategies and Key Insights.Journal of clinical medicine · 2025Article
- Risk factors for mortality in periprosthetic femur fractures about the hip-a retrospective analysis.International orthopaedics · 2025Article
- Management of Femoral Periprosthetic Fractures: An Institutional Experience at a District General Hospital.Cureus · 2024Article
- Periprosthetic and peri-implant femoral fractures and timeliness to surgery: A retrospective matched cohort study.Journal of experimental orthopaedics · 2024Article
- Fewer native and periprosthetic femoral fracture patients receive an orthogeriatric review and expedited surgery compared to hip fracture patients.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2024Observational
- Early and 1-year mortality of native geriatric distal femur fractures: A systematic review and time-to-event meta-analysis.Journal of clinical orthopaedics and trauma · 2024Review
- Periprosthetic Fractures around Total Hip Replacement-Is There a Rush to Fix?Journal of clinical medicine · 2023Article
- Periprosthetic fracture management of the proximal femur.OTA international : the open access journal of orthopaedic trauma · 2023Review
- Article
- Early Surgery Does Not Improve Outcomes for Patients with Periprosthetic Femoral Fractures-Results from the Registry for Geriatric Trauma of the German Trauma Society.Medicina (Kaunas, Lithuania) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrevious evidence has established that early surgery is beneficial to improve outcomes for individuals with native hip fractures in the elderly population. Patients who sustain a periprosthetic fracture have been demonstrated to have similar demographics and outcomes as those with native fractures around the hip and knee. We therefore set out to determine if there is a similar difference in perioperative outcomes between early and delayed surgery for periprosthetic fractures of the hip and knee through a systematic review and meta-analysis.
methodsLiterature search outputs were screened for studies meeting the inclusion criteria. The groups of early surgery and delayed surgery were defined by study authors. The primary outcome measure was 30 day mortality. Where there was sufficient study homogeneity, a random-effects meta-analysis was performed. Individual study risk of bias was assessed using the ROBINS-I criteria, with the GRADE criteria used for independent outcome evaluation. The review protocol was registered on PROSPERO prior to commencement (Registration number CRD42019149360).
resultsThe inclusion criteria was met in 11 studies (n = 3006). Mean time to surgery from admission for reporting studies was 64 h. 59.6% patients underwent early surgery as defined by the study authors. We identified a significantly lower risk of 30 day mortality for those with early surgery versus delayed surgery (RR 0.21; 95% CI 0.05, 0.90; p = 0.04, n = 2022). There were also significantly better outcomes for early versus delayed surgery regarding: medical complications, length of stay, transfusion risk, and reoperation. The quality of evidence for all the individual outcomes was low or very low.
conclusionsThere is evidence that delaying surgery in those with periprosthetic fractures of the hip and knee has a deleterious impact on mortality and other important patient outcomes. There are, however, notable limitations to the existing available literature, with further appropriately designed large-scale studies required to confirm these findings.
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Registered trials
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.