Prior fragility fractures are associated with a higher risk of 8-year complications following total shoulder arthroplasty
Main finding · All-cause revision TSA, cumulative incidenceResult — go to the resultHazard ratio 1.48 95% CI 1.24–1.74Authors' conclusion
Prior fragility fracture was a significant risk factor for revision, periprosthetic fracture, and secondary fragility fracture within 8 years of primary TSA.
Study context
- Population
- Patients aged 50 years and older who underwent total shoulder arthroplasty (TSA), large national database1:1 matched cohort
- Exposure
- Fragility fracture within 3 years before TSA vs no prior fragility fracture
- Prior fragility fracturen = 7,631
- Outcome
- Revision TSA, periprosthetic fracture (PPF) and secondary fragility fracture
- Follow-up
- 8 years
Methodological detailslarge national database, matched 1:1 on age, gender, Charlson Comorbidity Index (CCI), smoking, obesity, diabetes mellitus and alcohol use, Kaplan-Meier and Cox proportional hazards analyses
- Large national database
- Matched 1:1 on age, gender, CCI, smoking, obesity, diabetes mellitus and alcohol use
- Kaplan-Meier and Cox proportional hazards analyses
Main finding
All-cause revision TSA, cumulative incidence
Hazard ratio
1.48
95% CI 1.24–1.74
P < 0.001
By group
Prior fragility fracturevs No prior fragility fracture
HR 1.48 (95% CI 1.24–1.74); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Prior fragility fracture | No prior fragility fracture | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Periprosthetic fracture, cumulative incidence · 8 yearsMultivariable analysis · matched cohort | 3.8% | 1.4% | 2.98 (2.18–4.07) | P < 0.001 | |
| Secondary fragility fracture, cumulative incidence · 8 yearsMultivariable analysis · matched cohort | 46.5% | 10.1% | 8.39 (7.62–9.24) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Prior fragility fractures are associated with a higher risk of 8-year complications following total shoulder arthroplasty. Osteoporos Int. Published 20 June 2024. doi:10.
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