CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY

P. Baker; A. Scrimshire; A. Farrier; S. Jameson; P. Nagalingham; L. Kottam; R. Walker

doi:10.1302/1358-992X.2022.7.010

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CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY

The British Association for Surgery of the Knee (BASK) May 2022 Meeting, Newport, Wales, 17–18 May 2022.

P. Baker
A. Scrimshire
A. Farrier
S. Jameson
P. Nagalingham
L. Kottam
R. Walker

CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY

Baker P, Scrimshire A, Farrier A, et al. CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY. Orthop Procs. 2022;104-B(SUPP_7):10-10. doi:10.1302/1358-992X.2022.7.010

Baker, P., et al. “CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_7, 2022, pp. 10-10., https://doi.org/10.1302/1358-992X.2022.7.010

Baker, P., Scrimshire, A., Farrier, A., Jameson, S., Nagalingham, P., Kottam, L., & Walker, R. (2022). CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY. Orthopaedic Proceedings, 104-B(SUPP_7), 10-10. https://doi.org/10.1302/1358-992X.2022.7.010

Baker, P., Scrimshire, A., Farrier, A., Jameson, S., Nagalingham, P., Kottam, L. et al. (2022) “CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY.” Orthopaedic Proceedings, 104-B(SUPP_7), pp. 10-10. Available at: https://doi.org/10.1302/1358-992X.2022.7.010

Baker, P., A. Scrimshire, A. Farrier, S. Jameson, P. Nagalingham, L. Kottam, and R. Walker. “CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY.” Orthopaedic Proceedings 104-B, no. SUPP_7 (2022): 10-10. https://doi.org/10.1302/1358-992X.2022.7.010

Baker P, Scrimshire A, Farrier A, Jameson S, Nagalingham P, Kottam L, et al. CHARACTERISTICS, MANAGEMENT AND OUTCOMES FOR KNEE FEMORAL PERIPROSTHETIC FRACTURES: DATA FROM THE COMPOSE COHORT STUDY. Orthop Procs. 2022 Jul 1;104-B(SUPP_7):10-10. https://doi.org/10.1302/1358-992X.2022.7.010

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Abstract

Introduction

COMPOSE describes the demographics, fracture characteristics, management and associated outcomes of knee femoral periprosthetic fractures (KFPPF).

Methods

Multicentre retrospective cohort study conducted 01/01/2018-31/12/2018. Data collected included: patient demographics, social and mobility characteristics, fracture characteristics, management strategy and post-treatment outcomes (length of stay, reoperation, readmission, 30-day and 12-month mortality).

Results

785 PPFs from 27 NHS sites were included in the COMPOSE cohort. Of these 162 (21%) were related to an isolated knee prosthesis (151 femur, 10 tibia and 1 patella). The KFPPF group had a mean age of 81.1 years, 127 (84%) female, 114 (76%) living in their own home, with 99 (63%) reliant on walking aids/bedbound. Most fractures were B (58%) or C (35%) type and occurred around a primary cemented replacement (141,94%) at a mean of 8.2 years after surgery. 116 (76.8%) KFPPFs were treated operatively. Mean time to surgery was 5 days and the commonest surgical strategy was fixation alone (64%) vs revision+/-fixation (36%). Mean operative time was 126 minutes and 11 (10%) patients required ITU/HDU admission after surgery.

Mean LOS was 22 days and 47 patients (31%) experienced a complication prior to discharge. Overall, 5 patients (3%) had a further operation within 12 months, 7 (5%) were readmitted within 30 days and the 30-day and 12-month mortality were 6.6% and 23.2% respectively.

Conclusions

KFPPF patients are elderly and frail and have mortality, re-operation and readmission rates comparable to hip fracture patients. However, they wait longer for surgery and surgical treatment is more complex.