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, Héctor J.
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
A1 Álvarez-Ramos, Begoña Aránzazu
A1 Ganso-Pérez, Abel
A1 Cervera-Díaz, 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, 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 del PozoManrique, Pedro
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 R.
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 De Caso, Julio
A1 Martín-Marcuello, Jordi
A1 Benito-Mateo, Miguel
A1 Murillo-Vizuete, A. David
A1 Delgado, Luis Gracia
A1 dela Herrán, Gaspar
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 11-ene-2026