[The risk factors of periprosthetic fracture after hip arthroplasty:a meta-analysis]

Abstract

Objective: To explore risk factors of the periprosthetic fracture after hip arthroplasty.

Methods: Potential studies were searched in databases including Pubmed, Embase, Cochrane Library, CNKI as well as Wanfang Database up to November 2018 and references in related literatures. The methodological quality of literature was estimated by Newcastle-Ottawa Scale. Raw data were merged and tested mainly by Revmain 5.3.

Results: Seventeen studies in total were appropriate with 90 632 patients. The results revealed that it increased the risk of periprosthetic fracture after hip arthroplasty, including female (OR=1.62, 95%CI:1.44 to 1.82, P<0.01), revision(OR=3.78, 95%CI:1.88 to 7.58, P<0.01), preoperative diagnosis of rheumatoid arthritis(OR=1.60, 95%CI:1.07 to 2.37, P=0.02). Conversely, patients involved with cemented prosthesis fixation(OR=0.43, 95%CI:0.27 to 0.68, P<0.01) were less likely to suffer periprosthetic fracture after hip arthroplasty. Other factors were not significantly relevant to periprosthetic fracture after hip arthroplasty, including the age, preoperative diagnosis(femoral head necrosis, osteoarthritis, developmental dysplasia of the hip, femoral fracture, concomitant heart diseases) and American Society of Anesthesiologists >=3.

Conclusions: Orthopedics doctors should constantly be cantious about the risk factors including female, revision and diagnosis of rheumatoid arthritis. They are supposed to prevent the periprosthetic fracture by gentle operation during hip arthroplasty and monitoring the functional exercise after operations when the above risk factors occur.

Keywords: Arthroplasty, replacement, hip; Meta-analysis; Periprosthetic fractures; Risk factors.