Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study

The majority of knee arthroplasties (KAs) are performed in patients with osteoarthritis (OA). Although bone mass may be increased in these patients, subjects with knee OA may have an increased risk of hip fracture, possibly due to an increased severity of falls. However, in patients with KAs, risk o...

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Main Authors:	Lalmohamed, Arief, Opdam, Frans, Arden, Nigel K., Prieto-Alhambra, Daniel, van Staa, Tjeerd, Leufkens, Hubertus G. M., de Vries, Frank
Format:	Online
Language:	English
Published:	Springer-Verlag 2011
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271227/

id	pubmed-3271227
recordtype	oai_dc
spelling	pubmed-32712272012-02-17 Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study Lalmohamed, Arief Opdam, Frans Arden, Nigel K. Prieto-Alhambra, Daniel van Staa, Tjeerd Leufkens, Hubertus G. M. de Vries, Frank Article The majority of knee arthroplasties (KAs) are performed in patients with osteoarthritis (OA). Although bone mass may be increased in these patients, subjects with knee OA may have an increased risk of hip fracture, possibly due to an increased severity of falls. However, in patients with KAs, risk of hip fracture has not been studied extensively. We evaluated the association between KAs and hip fracture risk in a population-based case–control study using the Dutch PHARMO Record Linkage System (1991–2002, n = 33,104). Cases were patients with a first admission for hip fracture; controls were matched by age, gender, and geographic location. Neither group had a previous history of fracture. Time since first KA was calculated. Analyses were adjusted for disease and drug history. A 54% increased hip fracture risk was found in patients who underwent KA (adjusted [adj.] OR = 1.54, 95% CI 1.19–2.00). We found a strong effect modification by age in these patients: the youngest patients (aged 18–70 years) were at more increased risk for hip fracture (adj. OR = 2.76, 95% CI 1.16–6.59), while we could not detect a statistical increase in patients aged >80 years. Furthermore, the association tended to be greater during the first few years after surgery, although it did not reach statistical significance. We found that KAs are associated with a 54% increased risk of hip fracture, in particular among adult patients aged <71 years old. Fracture risk assessment could be considered in patients who are about to undergo a KA. Springer-Verlag 2011-12-18 2012-02 /pmc/articles/PMC3271227/ /pubmed/22179584 http://dx.doi.org/10.1007/s00223-011-9558-1 Text en © The Author(s) 2011
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Lalmohamed, Arief Opdam, Frans Arden, Nigel K. Prieto-Alhambra, Daniel van Staa, Tjeerd Leufkens, Hubertus G. M. de Vries, Frank
spellingShingle	Lalmohamed, Arief Opdam, Frans Arden, Nigel K. Prieto-Alhambra, Daniel van Staa, Tjeerd Leufkens, Hubertus G. M. de Vries, Frank Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
author_facet	Lalmohamed, Arief Opdam, Frans Arden, Nigel K. Prieto-Alhambra, Daniel van Staa, Tjeerd Leufkens, Hubertus G. M. de Vries, Frank
author_sort	Lalmohamed, Arief
title	Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
title_short	Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
title_full	Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
title_fullStr	Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
title_full_unstemmed	Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study
title_sort	knee arthroplasty and risk of hip fracture: a population-based, case–control study
description	The majority of knee arthroplasties (KAs) are performed in patients with osteoarthritis (OA). Although bone mass may be increased in these patients, subjects with knee OA may have an increased risk of hip fracture, possibly due to an increased severity of falls. However, in patients with KAs, risk of hip fracture has not been studied extensively. We evaluated the association between KAs and hip fracture risk in a population-based case–control study using the Dutch PHARMO Record Linkage System (1991–2002, n = 33,104). Cases were patients with a first admission for hip fracture; controls were matched by age, gender, and geographic location. Neither group had a previous history of fracture. Time since first KA was calculated. Analyses were adjusted for disease and drug history. A 54% increased hip fracture risk was found in patients who underwent KA (adjusted [adj.] OR = 1.54, 95% CI 1.19–2.00). We found a strong effect modification by age in these patients: the youngest patients (aged 18–70 years) were at more increased risk for hip fracture (adj. OR = 2.76, 95% CI 1.16–6.59), while we could not detect a statistical increase in patients aged >80 years. Furthermore, the association tended to be greater during the first few years after surgery, although it did not reach statistical significance. We found that KAs are associated with a 54% increased risk of hip fracture, in particular among adult patients aged <71 years old. Fracture risk assessment could be considered in patients who are about to undergo a KA.
publisher	Springer-Verlag
publishDate	2011
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271227/
_version_	1611503474854330368

Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case–Control Study

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