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The influence of pre-existing radiographic osteoarthritis on functional outcome after trochanteric fracture

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Abstract

Purpose

It is crucially important to optimise functional outcome after fixation of trochanteric femoral fractures. While a number of risk factors that predict a poor clinical course have been identified, the influence of pre-existing radiographic osteoarthritis (OA) of the hip is unclear.

Methods

The influence of pre-existing radiographic OA of the hip on short- to mid-term functional outcome was prospectively analysed in a cohort of patients undergoing proximal femoral nailing for trochanteric fracture. OA was graded according to Kellgren and Lawrence; functional outcome was assessed at six and 12 months by the Harris hip score (HHS), the timed up and go (TUG) test and the Barthel Index.

Results

Our cohort comprised 188 patients (58 were male and 130 female), with a mean age of 82 years. At six and 12 months postoperatively, the HHS (p < 0.001 and p = 0.008, respectively) and Barthel Index (p < 0.001 and p = 0.02, respectively) correlated significantly with the grade of pre-existing OA. After adjustment for confounding variables, there was a significant association between the grade of pre-existing OA and the HHS at six months (p = 0.02). Although we observed trends suggestive of other relationships, none reached statistical significance.

Conclusions

Pre-existing radiographic OA of the hip is an important determinant of clinical outcome in elderly patients with a trochanteric femoral fracture. Further studies will be needed to establish the most effective means of restoring hip function after trochanteric femoral fracture in patients with radiographic OA of the hip.

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Abbreviations

ASA:

American Society of Anesthesiologists

FU:

Follow-up

HSS:

Harris hip score

MMSE:

Mini-Mental State Examination

NSA:

Neck shaft angle

OA:

Osteoarthritis

PFF:

Proximal femoral fracture

SD:

Standard deviation

TUG:

Timed up and go

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany

    Christoph Kolja Boese

  2. Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany

    Benjamin Buecking, Tim Schwarting, Florian Debus, Steffen Ruchholtz, Christoph Bliemel, Michael Frink & Philipp Lechler

Authors
  1. Christoph Kolja Boese
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  2. Benjamin Buecking
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  3. Tim Schwarting
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  4. Florian Debus
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  5. Steffen Ruchholtz
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  6. Christoph Bliemel
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  7. Michael Frink
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  8. Philipp Lechler
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Correspondence to Philipp Lechler.

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Boese, C.K., Buecking, B., Schwarting, T. et al. The influence of pre-existing radiographic osteoarthritis on functional outcome after trochanteric fracture. International Orthopaedics (SICOT) 39, 1405–1410 (2015). https://doi.org/10.1007/s00264-014-2663-9

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  • DOI: https://doi.org/10.1007/s00264-014-2663-9

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