RT info:eu-repo/semantics/article
T1 Optimizing periprosthetic fracture management and in-hospital outcome: insights from the PIPPAS multicentric study of 1387 cases in Spain
A1 Aguado Hernández, Héctor José
A1 Castillón Bernal, Pablo
A1 Teixidor Serra, Jordi
A1 García Sánchez, Yaiza
A1 Muñoz Vives, Josep M.
A1 Camacho Carrasco, Pilar
A1 Jornet Gibert, Montsant
A1 Ojeda Thies, Cristina
A1 García Portabella, Pablo
A1 Pereda Manso, Adela
A1 Mateos Álvarez, Elvira
A1 Manzano Mozo, Javier
A1 Carrillo Gómez, Raquel
A1 País Ortega, Sergio
A1 García Virto, Virginia
A1 Noriega González, David César
A1 Álvarez Ramos, Begoña Aranzazu
A1 Ganso Pérez, Abel
A1 Cervera Díaz, María del Carmen
A1 Plata García, María
A1 Ortega Briones, Alina
A1 Berrocal Cuadrado, Juan
A1 Criado del Rey Machimbarrena, Diego
A1 Salvador, Jordi
A1 Rey, Laura
A1 Tomás Hernández, Jordi
A1 Selga Marsà, Jordi
A1 Andrés Peiró, José Vicente
A1 Querolt Coll, Jordi
A1 Triana, Guillermo
A1 Vives Barquiel, Marian
A1 Renau Cerrillo, Marina
A1 Campuzano Bitterling, Borja
A1 Hernández, José M
A1 Ostilla, Ricardo
A1 Carreras Castañer, Anna
A1 Torner, Pere
A1 Díaz Suárez, Rebeca
A1 Fernández, Eliam Ajuria
A1 Olaya González, Carlos
A1 Fernández Villán, María
A1 García de Cortázar, Unai
A1 Arrieta, Mirentxu
A1 Escobar, Daniel
A1 Castrillo, Estíbaliz
A1 Balvis Balvis, Patricia
A1 Rodríguez Arenas, Mónica
A1 García Pérez, Ángela
A1 Moreta, Jesús
A1 Bidea, Iñigo
A1 Jiménez Urrutia, Xabier
A1 Olías López, Beatriz
A1 Boluda Mengod, Juan
A1 González Martín, David
A1 Bárcena Goitiandia, Leopoldo
A1 López Dorado, Daniel
A1 Borrás Cebrián, Juan Carlos
A1 García Aguilera, David
A1 Freile Pazmiño, Patricio Andrés
A1 Suárez Suárez, Miguel Ángel
A1 Lanuza Lagunilla, Lucía
A1 García Arias, Antonio
A1 Sánchez Saz, Jaime
A1 García Coiradas, Javier
A1 Valle Cruz, José
A1 Mora Fernández, Jesús
A1 Cano Leira, María Ángeles
A1 Rieiro, Guillermo
A1 Benjumea Carrasco, Antonio
A1 Priego Sánchez, Rodrigo Jesús
A1 Sánchez Pérez, Coral
A1 Guadilla Arsuaga, Jorge
A1 Fernández Juan, Alexis
A1 Sánchez, Plácido
A1 Ricón, Javier
A1 Fuentes Díaz, Alfonso
A1 García García, Elena M.
A1 Cuadrado  Abajo, Francisco
A1 García Portal, Gonzalo
A1 Pozo Manrique, Pedro del
A1 Castillo del Pozo, Virginia
A1 Garcia Navas, Francisco Manuel
A1 García Paredero, Ester
A1 Beteta Robles, Teresa
A1 Guijarro Valtueña, Ainhoa
A1 Gutiérrez Baiget, Gonzalo
A1 Alonso García, Noelia
A1 Navas Pernía, Inés
A1 Ariza Herrera, Diana
A1 Vilanova, Joan
A1 Videla Cés, Miquel
A1 Serra Porta, Teresa
A1 Vázquez García, César
A1 Carrasco Becerra, Carmen
A1 Pena Paz, Silvia
A1 Otero Naveiro, Víctor
A1 Fernández-Billón Castrillo, Inés
A1 Martínez Menduiña, Amaia
A1 Hernández Galera, Carolina
A1 Fernández Dorado, Fátima
A1 Madrigal López, María
A1 Murcia Asensio, Antonio
A1 Galián Muñoz, Elena
A1 Castro Sauras, Ángel
A1 Espallargas Doñate, Teresa
A1 Royo Agustín, María
A1 Plaza Salazar, Nuria
A1 Gámez Asunción, Carla
A1 Muñoz Vicente, Adrián
A1 Pareja Sierra, Teresa
A1 Benito Santamaría, Jennifer
A1 Cuenca Copete, Alejandro
A1 Verdejo González, Ana
A1 González Montero, Blas
A1 Giraldo Vegas, Luis Alejandro
A1 Alonso Viana, Laura
A1 Díez Pérez, Eduardo José
A1 Briso-Montiano, Ricardo
A1 Andrés, Ana Isabel
A1 Mingo Robinet, Juan
A1 Naharro Tobío, María
A1 Escudero Martínez, Emma
A1 Serrano Sanz, Jorge
A1 Peñalver Matamoros, J. M.
A1 Fernàndez Poch, Núria
A1 Martínez Carreres, Laia
A1 Macho Mier, María
A1 Martín Hernández, Carlos
A1 Laclériga Giménez, Antonio Francisco
A1 Saló Cuenca, José Carlos
A1 Salamanca Ontiveros, César
A1 Espona Roselló, Jordi
A1 Altemir Martínez, Victoria
A1 Criado Albillos, Guillermo
A1 Cunchillos Pascual, Jorge
A1 Millán Cid, Mercedes
A1 Cabello Benavides, Hugo Gabriel
A1 Martínez-Íñiguez Blasco, Jorge
A1 Sevilla Ortega, Paloma
A1 Cano, Juan Ramón
A1 Ramírez, Alicia
A1 Marqués López, Fernando
A1 Martínez Díaz, Santos
A1 Carabelli, Guido S.
A1 Slullitel, Pablo A
A1 Astore, Ignacio
A1 Boietti, Bruno Rafael
A1 Hernández Pascual, Carlos
A1 Marín Sánchez, Javier
A1 Córdova Peralta, Julio César
A1 Dot Pascuet, Iván
A1 Pereira Mosquera, Eduardo
A1 Martín Antúnez, Javier
A1 Pérez, José María
A1 Mandía Martínez, Alfonso
A1 Caso Rodríguez, Julio de
A1 Martín Marcuello, Jordi
A1 Benito Mateo, Miguel
A1 Murillo Vizuete, A. David
A1 Gracia Delgado, Luis
A1 Herrán, Gaspar de la
A1 Nunes, Nahikari
A1 Pérez Coto, Ivan
A1 González Panisello, María Rosa
A1 Iglesias Fernández, Susana
A1 Ruete Gil, Gorka Luis
A1 Ramos García, Sergio
A1 Villarreal, Juan Pablo
K1 Outcome
K1 Periprosthetic fracture
K1 Mortality
K1 Replacement
K1 Fracture fixation
K1 Frailty
K1 Management
K1 Epidemiology
K1 Incidence
K1 Geriatric co-management
AB BackgroundThe incidence of all periprosthetic fractures (PPF), which require complex surgical treatment associated with high morbidity and mortality, is predicted to increase. The evolving surgical management has created a knowledge gap regarding its impact on immediate outcomes. This study aimed to describe current management strategies for PPF and their repercussions for in-hospital outcomes as well as to evaluate their implications for the community.MethodsPIPPAS (Peri-Implant PeriProsthetic Survival Analysis) was a prospective multicentre observational study of 1387 PPF performed during 2021. Descriptive statistics summarized the epidemiology, fracture characteristics, management, and immediate outcomes. A mixed-effects logistic regression model was employed to evaluate potential predictors of in-hospital mortality, complications, discharge status, and weight-bearing restrictions.ResultsThe study encompassed 32 (2.3%) shoulder, 4 (0.3%) elbow, 751 (54.1%) hip, 590 (42.5%) knee, and 10 (0.7%) ankle PPF. Patients were older (median 84 years, IQR 77–89), frail [median clinical frailty scale (CFS) 5, IQR 3–6], presented at least one comorbidity [median Charlson comorbidity index (CCI) 5, IQR 4–7], were community dwelling (81.8%), and had outdoor ambulation ability (65.6%). Femoral knee PPF were most frequently associated with uncemented femoral components, while femoral hip PPF occurred equally in cemented and uncemented stems. Patients were managed surgically (82%), with co-management (73.9%), through open approaches (85.9%) after almost 4 days (IQR, 51.9–153.6 h), with prosthesis revision performed in 33.8% of femoral hip PPF and 6.5% of femoral knee PPF. For half of the patients, the discharge instructions mandated weight-bearing restrictions. In-hospital mortality rates were 5.2% for all PPF and 6.2% for femoral hip PPF. Frailty, age > 84 years, mild cognitive impairment, CFS > 3, CCI > 3, and non-geriatric involvement were candidate predictors for in-hospital mortality, medical complications, and discharge to a nursing care facility. Management involving revision arthroplasty by experienced surgeons favoured full weight-bearing, while an open surgical approach favoured weight-bearing restrictions.ConclusionsCurrent arthroplasty fixation check and revision rates deviate from established guidelines, yet full weight-bearing is favoured. A surgical delay of over 100 h and a lack of geriatric co-management were related to in-hospital mortality and medical complications. This study recommends judicious hypoaggressive approaches. Addressing complications and individualizing the surgical strategy can lead to enhanced functional outcomes, alleviating the economic and social burdens upon hospital discharge.
PB Springerlink
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/81220
UL https://uvadoc.uva.es/handle/10324/81220
LA eng
NO J Orthop Traumatol. 2024 Mar 7;25(1):13.
NO Producción Científica
DS UVaDOC
RD 07-abr-2026