Adequate surgical treatment of periprosthetic femoral fractures following hip arthroplasty does not correlate with functional outcome and quality of life

Abstract

This study aimed to analyse functional outcome and quality of life (QoL) after surgical treatment of periprosthetic femoral fractures (PPF) following total hip arthroplasty (THA). This retrospective study assessed 67 patients from 2005 to 2012. Epidemiologic data, surgical details, comorbidities, deaths and postoperative complications were recorded. Functional assessment included Harris Hip Score (HHS) and range of motion (ROM); QoL was assessed using the Short-Form Health Survey of 36 questions (SF-36) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Mean HHS was 69 ± 21 and ROM 96° ± 17°. Mean SF-36 and WOMAC scores revealed 44 ± 7.2 and 18.9 ± 19.6, respectively. The complication rate was 25.4%; 23.7% of patients died. Analysis revealed no statistical influence on final outcome as a function of fracture type or treatment strategy. Comorbidities seem to influence functional outcome. PPF following THA are accompanied by a perceptible decline of function and remarkably high complication rates. In contrast to fracture classification and treatment type, American Society of Anesthesiologists (ASA) score predicts outcome.