Evidence map›Paper›PMID 37620685›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Periprosthetic fracture following anterior approach or dislocation after posterior approach: which one is the lesser evil?

Jeroen C F Verhaegen, Tom Schmidt-Braekling, Roger Wei, Ottawa Arthroplasty Group, Paul E Beaulé, George Grammatopoulos

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Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
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  3. Article
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

6 authors at 1 institution in 2 countries.

Jeroen C F VerhaegenDivision of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, 501 Smyth RoadSuite CCW 1638, Ottawa, ON, K1H 8L6, Canada.
Tom Schmidt-BraeklingDivision of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, 501 Smyth RoadSuite CCW 1638, Ottawa, ON, K1H 8L6, Canada.
Roger WeiDivision of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, 501 Smyth RoadSuite CCW 1638, Ottawa, ON, K1H 8L6, Canada.
Ottawa Arthroplasty Group
Paul E BeauléDivision of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, 501 Smyth RoadSuite CCW 1638, Ottawa, ON, K1H 8L6, Canada.
George GrammatopoulosDivision of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, 501 Smyth RoadSuite CCW 1638, Ottawa, ON, K1H 8L6, Canada. ggrammatopoulos@toh.ca.ORCID http://orcid.org/0000-0002-7444-9498
Ottawa Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe most common approaches in total hip arthroplasty (THA) have different complication profiles; anterior-approach (AA-THA) has an increased risk of periprosthetic fractures (PPF); posterior-approach (PA-THA) is associated with higher dislocation risk. However, the relative severity of one versus the other is unknown. This study aims to compare outcome of patients who suffered PPF after AA-THA with those that sustained dislocation after PA-THA.

methodsThis is a retrospective, single-center, multi-surgeon, consecutive case-series of primary THA patients. In a cohort of 9867 patients who underwent THA, 79 fulfilled the approach-specific, post-operative complication criteria, of which 44 were PPF after AA-THA and 35 with dislocation after PA-THA (age 67.9 years (range: 38.0-88.1), 58.2% women). Outcome included complication- and revision- rates, and patient-reported outcomes including Oxford Hip Score (OHS).

resultsAt 5.8 years follow-up (range: 2.0-18.5), reoperation was more common in the dislocation after PA-THA group (23/35 vs. 20/44; p = 0.072). Change of surgical approach occurred in 15/20 of patients with PPF after AA-THA, but none in those with dislocation after PA-THA. Following re-operation, complication rate was greater in the PPF group (9/20 vs. 4/23; p = 0.049). At latest follow-up, OHS were superior in the PPF after AA-THA group [42.6 (range: 25.0-48.0) vs. 36.6 (range: 21.0-47.0); p = 0.006].

conclusionDislocation following PA-THA is more likely to require revision. However, PPF following AA-THA requires more often a different surgical approach and is at higher risk of complications. Despite the increased surgical burden post-operative PROMs are better in the peri-prosthetic fracture group, especially in cases not requiring reoperation. LEVEL OF EVIDENCE: III, case-control study.

Indexed as

Arthroplasty, Replacement, HipHip DislocationHip ProsthesisJoint DislocationsPeriprosthetic FracturesAgedCase-Control StudiesFemaleHumansMaleReoperationRetrospective StudiesApproachComplicationsDislocationOutcomePeri-prosthetic fractureTotal hip arthroplasty

Identifiers

PMID37620685
OpenAlexW4386126983

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.