PURPOSE OF THE STUDY The aim of this prospective study was to investigate whether female gender and revision surgery were significant risk factors for intra-operative periprosthetic fractures during total hip arthroplasty (THA). MATERIAL AND METHODS The group investigated comprised the patients who, in the period 1995-2009, sustained an intra-operative periprosthetic fracture during primary or revision THA.
The patients were treated by a therapeutic procedure based on the Vancouver system. The results were related to the total number of patients undergoing THA in that period, Statistical analysis was performed using Pearson's chi(2) test at the 5% significance level.
This continuous 15-year study on patients with intra-operative periprosthetic fractures of the hip has allowed us to conclude that these fractures occur more frequently in women than in men, and that more serious fractures (Vancouver type-B) are significantly more frequent during revision than primary THA. The higher incidence in women is, to a great part, accounted for by osteoporosis of the skeleton in elderly people.
In revision THA, poor bone quality plays a role as well as osteolysis due to polyethylene granuloma which may be present.