ArticlePLoS medicine2024
The incidence of postoperative periprosthetic femoral fracture following total hip replacement: An analysis of UK National Joint Registry and Hospital Episodes statistics data.
Article in PLoS medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Management of infected periprosthetic fracture of hip and knee: a systematic review of the literature.EFORT open reviews · 2026Pooled it
- Intraoperative acetabular periprosthetic fracture (IAPF) in total hip arthroplasty: a systematic review of outcomes and complications in conservative and surgical treatment.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Outcomes of cemented and hybrid primary total hip arthroplasty for osteoarthritis: A systematic review with narrative synthesis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- The first decade of data from the Irish National Orthopaedic Register: trends in hip and knee arthroplasty, implant utilisation and patient outcomes.International orthopaedics · 2026Article
- Effect of periprosthetic greater trochanter fractures (Vancouver AG) on primary stability of the femoral stem in total hip arthroplasty: a biomechanical micromotion analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Maximizing stem body size may reduce the risk of postoperative periprosthetic fractures : an analysis of 2,757 CPT femoral components.Bone & joint open · 2026Article
- Periprosthetic fractures after hip and knee arthroplasty in France : national trends and future projections.Bone & joint open · 2026Article
- What influences UK-practising consultant hip surgeons' decision-making about implant fixation? An interview study.BMJ open · 2026Article
- Hook plate fixation and the importance of anatomical reduction in periprosthetic hip fractures: a retrospective single-centre study at a United Kingdom District General Hospital.International orthopaedics · 2026Article
- Impact of Femoral Morphology and Stem Design on Intraoperative Periprosthetic Femoral Fractures in Cementless Total Hip Arthroplasty.Journal of clinical medicine · 2026Article
- The acute healthcare burden of periprosthetic fractures in a regional orthopaedic trauma unit.Irish journal of medical science · 2026Article
- Comparison of 20-year results of total hip arthroplasty using first-generation annealed highly cross-linked polyethylene and zirconia heads in patients aged ≤ 50 and > 50 years.Archives of orthopaedic and trauma surgery · 2026Article
- Introducing the Universal Periprosthetic Femur Fracture (UPFF) Classification: All Fractures Femur.Journal of clinical medicine · 2026Article
- Patient-reported outcomes following operatively managed periprosthetic femoral fractures around Exeter polished taper slip femoral components.Bone & joint open · 2026Article
- CementedWorld journal of orthopedics · 2026Article
- Periprosthetic fractures around chronically infected total hip arthroplasties: a case series and pragmatic two-stage treatment framework.Journal of bone and joint infection · 2026Article
- Predictors of short-term outcomes after postoperative periprosthetic femoral fracture : a UK linked data analysis.Bone & joint open · 2025Article
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- Between-hospital variability in the management and outcomes of postoperative periprosthetic femoral fractures.Bone & joint open · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative periprosthetic femoral fracture (POPFF) after total hip replacement (THR) requires complex surgery and is associated with a high morbidity, mortality, and cost. Although the United Kingdom based National Joint Registry (NJR) captures over 95% of THRs treated with revision, before June 2023 it did not capture POPFF treated with fixation. We aimed to estimate the incidence and epidemiology of POPFF treated with either surgery in England. METHODS AND
findingsWe performed a retrospective analysis of a mandatory, prospective database (NJR) linked to Hospital Episode Statistics (HES). All linkable primary THRs between 01/01/2004 and 31/12/2020 were included. Revision or fixation of POPFF were identified using a combination of procedural and diagnosis codes. We identified 809,832 THRs representing 5,542,332 prosthesis years at risk. A total of 5,100 POPFF were identified that had been surgically treated by revision, fixation, or both, and 2,831 of these fractures were treated with fixation alone, meaning 56% were not represented with revision data alone. The incidence of POPFF needing surgery was 0.92 (95% CI 0.90, 0.95) per 1,000 prostheses years. This incidence was higher in patients over the age of 70 at the time of primary THR (1.31 [95% CI 1.26, 1.35] per 1,000 prostheses years) and for patients who underwent THR for hip fracture (2.19 [95% CI 1.97, 2.42] per 1,000 prostheses years). This incidence appears to be increasing year on year. The cumulative probability of sustaining a POPFF within 10 years of THR was 1% and over 15% of patients died within 1 year of surgery for a POPFF.
conclusionsTo date, the incidence of POPFF may have been underestimated with over 50% of cases missed if the case identification in this study is correct. After including these cases, we observed that POPFF is the largest reason for major reoperation following THR and patients sustaining these injuries have a high risk of death. The prevention and treatment of POPFF and requires further resource allocation and research.
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