{
    "abstract": "Periprosthetic femoral fracture (PPFF) is a serious complication following hip arthroplasty. The objective of this study was to determine the risk factors for PPFF following hip arthroplasty from existing studies.\nA comprehensive systematic search was performed in 4 databases: Pubmed, Embase, Web of Science, and Cochrane Library. The last search was carried out on 26th July 2024. We focused on identifying risk factors for PPFF following\u00a0hip arthroplasty. Study eligibility required PPFF as an outcome and reporting of associated risk factors. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS), with evidence certainty evaluated via Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Meta-analyses employed both fixed-effect and random-effects models to pool odds ratios for identified risk factors.\nOut of 1553 articles, 36 studies published between 2006 and 2024 were included. Risk factors associated with increased incidence of PPFF ranges from very Low to High. High-quality evidence supported the use of uncemented stems (Odds Ratio [OR]: 3.36, 95% Confidence Interval [95% CI]: 3.02-3.74), major teaching hospital (OR: 2.04, 95% CI: 1.37-3.05). Moderate-quality evidence: female gender (OR: 1.60, 95% CI: 1.43-1.78), morbid obesity (OR: 1.44, 95% CI: 1.01-2.16), higher Deyo-Charlson index (OR: 1.44, 95% CI: 1.18-1.77), rheumatoid arthritis (OR: 1.89, 95% CI: 1.16-3.06), femoral Dorr type C (OR: 4.23, 95% CI: 2.82-6.33). Low evidence: age > 70\u2009years (OR: 1.67, 95% CI: 1.19-2.34), revision hip arthroplasty (OR: 2.60, 95% CI: 1.59-4.27). BMI > 30 and history of hip surgery are not the risk (very low). Diagonized as osteoarthritis before surgery is a protective factor (OR:0.51, 95%CI: 0.40-0.65, quality\u2009=\u2009High).\nThis meta-analysis provided some low-to-high evidence about the risk of PPFF following hip arthroplasty. It's recommended\u00a0that clinicians consider these risk factors when evaluating patients for hip arthroplasty and take steps to mitigate their impact, like optimizing\u00a0patients health preoperatively, using\u00a0cemented stems, and monitoring\u00a0high-risk patients closely.",
    "authors": [
        {
            "affiliation": "Department of Orthopaedics & Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.\nThe First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.",
            "firstname": "Wei-Qiang",
            "initials": "WQ",
            "lastname": "Zhao"
        },
        {
            "affiliation": "The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.",
            "firstname": "Ke-Qin",
            "initials": "KQ",
            "lastname": "Yu"
        },
        {
            "affiliation": "Department of Orthopaedics & Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.\nThe First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.",
            "firstname": "Rong-Zhen",
            "initials": "RZ",
            "lastname": "Xie"
        },
        {
            "affiliation": "Department of Orthopaedics & Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.\nThe First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.",
            "firstname": "Yu-Feng",
            "initials": "YF",
            "lastname": "Liang"
        },
        {
            "affiliation": "Department of Orthopaedics & Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.\nThe First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.",
            "firstname": "Jie-Feng",
            "initials": "JF",
            "lastname": "Huang"
        }
    ],
    "conclusions": "This meta-analysis provided some low-to-high evidence about the risk of PPFF following hip arthroplasty. It's recommended\u00a0that clinicians consider these risk factors when evaluating patients for hip arthroplasty and take steps to mitigate their impact, like optimizing\u00a0patients health preoperatively, using\u00a0cemented stems, and monitoring\u00a0high-risk patients closely.",
    "copyrights": null,
    "doi": "10.1080/07853890.2025.2494679",
    "journal": "Annals of medicine",
    "keywords": [
        "Periprosthetic femoral fracture",
        "complication",
        "hip arthroplasty",
        "risk factor"
    ],
    "methods": null,
    "publication_date": "2025-04-23",
    "pubmed_id": "40265296",
    "results": "Out of 1553 articles, 36 studies published between 2006 and 2024 were included. Risk factors associated with increased incidence of PPFF ranges from very Low to High. High-quality evidence supported the use of uncemented stems (Odds Ratio [OR]: 3.36, 95% Confidence Interval [95% CI]: 3.02-3.74), major teaching hospital (OR: 2.04, 95% CI: 1.37-3.05). Moderate-quality evidence: female gender (OR: 1.60, 95% CI: 1.43-1.78), morbid obesity (OR: 1.44, 95% CI: 1.01-2.16), higher Deyo-Charlson index (OR: 1.44, 95% CI: 1.18-1.77), rheumatoid arthritis (OR: 1.89, 95% CI: 1.16-3.06), femoral Dorr type C (OR: 4.23, 95% CI: 2.82-6.33). Low evidence: age > 70\u2009years (OR: 1.67, 95% CI: 1.19-2.34), revision hip arthroplasty (OR: 2.60, 95% CI: 1.59-4.27). BMI > 30 and history of hip surgery are not the risk (very low). Diagonized as osteoarthritis before surgery is a protective factor (OR:0.51, 95%CI: 0.40-0.65, quality\u2009=\u2009High).",
    "title": "Risk factors for periprosthetic femoral fractures following hip arthroplasty: a systematic review and meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788503ccc2c0>"
}