Tuesday July 2014 (foodconsumer.org) -- Patients who have received total hip arthroplasty should be carefully followed up to assess the risk factors and reduce the risk of periprosthetic fractures, a new review suggests.

The review of previous study reports published prior to Dec 2013 in major databases including MEDLINE, EMBASE, WEB OF SCIENCE, SCOPUS, AND COCHRANCE CENTRAL identifies female gender, advanced age, revision, rheumatoid arthritis, osteonecrosis, and implant type of Exeter as risk factors for periprosthetic fractures in patients who had received total hip arthroplasty.

Reviewers went through the data from seven studies of 1069 cases of periprosthetic fractures and 74,776 controls and found those at an advanced age, who experienced revision or suffered rheumatoid arthritis at 320%, 330% or 150% increased risk of periprosthetic fractures, respectively, compared with those at a young age, without revision and who did not have rheumatoid arthritis.

In addition, those being female, or suffering from osteonecrosis  or using implant type of Exeter were 50% more likely in each case to sustain periprosthetic fractures.

Interestingly, having osteoarthritis (vs not) seemed to reduce the risk of periprosthetic fractures in patients receiving total hip arthroplasty.

The study suggests "These medical conditions as reminder should be kept in clinicians' mind and close follow-up should be implemented in patients involved for preventing the occurrence of periprosthetic fractures after total hip arthroplasty." (David Liu)

Zhu Y, Chen W, Sun T, Zhang X, Liu S, Zhang Y.  Risk factors for the periprosthetic fracture after total hip arthroplasty: a systematic review and meta-analysis.  Scand J Surg. 2014 Jul 22.