The impact of prior fragility fractures on long-term periprosthetic fracture risk following total knee arthroplasty
Authors' conclusion
Recent FF before TKA is associated with increased risk for additional FF and PPF within 8 years following TKA.
Study context
- Population
- Patients at least 50 years of age who underwent elective TKA, PearlDiver Database
- Participants
- 7,410 vs 712,954
- Exposure
- Prior fragility fracture (FF) within 3 years before TKA vs no prior FF
- Prior FFn = 7,410
- No prior FFn = 712,954reference
- Outcome
- Secondary fragility fracture (FF), periprosthetic fracture (PPF) and all-cause revision TKA
- Follow-up
- 8 years
Methodological detailsPearlDiver Database, Kaplan Meier analysis, Cox proportional hazard analysis, adjusted for covariates
- PearlDiver Database
- Kaplan Meier analysis
- Cox proportional hazard analysis
- Adjusted for covariates
Main finding
As reported in the abstract
Hazard ratio (secondary FF)
2.73
P < 0.001
Prior FF
Hazard ratio (PPF)
1.86
P < 0.001
Prior FF
Observational data: associations, not effects.
Further findings
All-cause revision · 8 years
- Patients with prior FF were not at increased risk for all-cause revision within this period
Prior FF prevalence and coded bone diagnoses · at time of TKA
- Patients with a FF within three years of TKA
- 1.0%
- Coded osteoporosis among prior FF
- 22.6%
- Coded osteopenia among prior FF
- 10.9%
Original publication
The impact of prior fragility fractures on long-term periprosthetic fracture risk following total knee arthroplasty. Osteoporos Int. Published 11 May 2023. doi:10.
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