Research Article| Volume 27, ISSUE 8, P1507-1512, September 2012

Patient Factors Predict Periprosthetic Fractures After Revision Total Hip Arthroplasty

  • Jasvinder A. Singh
    Reprint requests: Jasvinder A. Singh, MBBS, MPH, University of Alabama, Faculty Office Tower 805B, 510 20th St S, Birmingham, AL 35294.
    Medicine Service and Center for Surgical Medical Acute care Research and Transitions (C-SMART), Birmingham VA Medical Center, Birmingham, Alabama

    Department of Medicine, University of Alabama, Birmingham, Alabama

    Division of Epidemiology, School of Public Health, University of Alabama, Birmingham, Alabama

    Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
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  • Matthew R. Jensen
    Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
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  • David G. Lewallen
    Division of Epidemiology, School of Public Health, University of Alabama, Birmingham, Alabama

    Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
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Published:February 17, 2012DOI:


      We assessed important patient risk factors for postoperative periprosthetic fractures after revision total hip arthroplasty (THA) using prospectively collected Institutional Joint Registry data. We used univariate and multivariable-adjusted Cox regression analyses. There were 330 postoperative periprosthetic fractures after 6281 revision THAs. In multivariable-adjusted analyses, hazard ratio (95% confidence interval) of periprosthetic fracture was higher for women (1.66 [1.32-2.080], P < .001), a higher Deyo-Charlson comorbidity index of 2 (1.46 [1.03-2.07]) and index of 3+ (2.01 [1.48-2.73]; overall, P < .001), and operative diagnosis, especially previous nonunion (5.76 [2.55-13.02]; overall, P < .001). Hazard ratio was lower in patients 61 to 70 years old (0.64 [0.49-0.84]) and 71 to 80 years old (0.57 [0.43-0.76]) compared with those younger than 60 years (overall, P < .0001). Our study identified important modifiable and unmodifiable risk factors for fractures after revision THA.


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