Cargando…
Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study
Introduction: The purpose of this study was to determine whether immediate weight-bearing as tolerated increased the risk of implant failure and decreased functional outcomes compared with restricted weight-bearing. Methods: From January 2010 to December 2018, 1,125 consecutive patients (≥65 years)...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720847/ https://www.ncbi.nlm.nih.gov/pubmed/34988100 http://dx.doi.org/10.3389/fmed.2021.795595 |
_version_ | 1784625211047411712 |
---|---|
author | Jia, Xiaoyang Qiang, Minfei Zhang, Kun Han, Qinghui Wu, Ying Chen, Yanxi |
author_facet | Jia, Xiaoyang Qiang, Minfei Zhang, Kun Han, Qinghui Wu, Ying Chen, Yanxi |
author_sort | Jia, Xiaoyang |
collection | PubMed |
description | Introduction: The purpose of this study was to determine whether immediate weight-bearing as tolerated increased the risk of implant failure and decreased functional outcomes compared with restricted weight-bearing. Methods: From January 2010 to December 2018, 1,125 consecutive patients (≥65 years) with intertrochanteric fractures were identified. Of them, 130 patients were excluded, resulting in 995 patients in final cohort (563 receiving immediate weight-bearing and 432 receiving restricted weight-bearing). Propensity score (PS) matching yielded 403 patient pairs. Primary outcome was implant failure at 12 months. Secondary outcomes were implant failure at 3 months, functional outcomes at 12 months, and time to full weight-bearing. Results: Among 806 patients who were matched by PS, the mean age was 77.8 years (SD, 7.6), and 603 patients (74.8%) were women. After matching, there was no significant difference between immediate (10.0% [39/389]) and restricted (9.1%, [35/385]) weight-bearing for implant failure at 12 months (absolute risk difference, 0.93% [95% CI, −3.26 to 5.13%]; RR, 1.11 [95% CI, 0.69 to 1.80]; p = 0.66). Additionally, no significant difference was seen for implant failure at 3 months and functional outcomes at 12 months. Patients with immediate weight-bearing had shorter time to full weight-bearing (mean [SD], 87.6 days [7.5] vs. 121.3 days [11.0]; mean difference, −33.7 [95% CI, −35.0 to −32.3]; p < 0.001). Conclusions: Among older patients with intertrochanteric fractures, receipt of immediate weight-bearing as tolerated did not increase risks of implant failure or worsen functional outcomes compared with receipt of restricted weight-bearing. However, patients receiving immediate weight-bearing had a shorter time to full weight-bearing. |
format | Online Article Text |
id | pubmed-8720847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87208472022-01-04 Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study Jia, Xiaoyang Qiang, Minfei Zhang, Kun Han, Qinghui Wu, Ying Chen, Yanxi Front Med (Lausanne) Medicine Introduction: The purpose of this study was to determine whether immediate weight-bearing as tolerated increased the risk of implant failure and decreased functional outcomes compared with restricted weight-bearing. Methods: From January 2010 to December 2018, 1,125 consecutive patients (≥65 years) with intertrochanteric fractures were identified. Of them, 130 patients were excluded, resulting in 995 patients in final cohort (563 receiving immediate weight-bearing and 432 receiving restricted weight-bearing). Propensity score (PS) matching yielded 403 patient pairs. Primary outcome was implant failure at 12 months. Secondary outcomes were implant failure at 3 months, functional outcomes at 12 months, and time to full weight-bearing. Results: Among 806 patients who were matched by PS, the mean age was 77.8 years (SD, 7.6), and 603 patients (74.8%) were women. After matching, there was no significant difference between immediate (10.0% [39/389]) and restricted (9.1%, [35/385]) weight-bearing for implant failure at 12 months (absolute risk difference, 0.93% [95% CI, −3.26 to 5.13%]; RR, 1.11 [95% CI, 0.69 to 1.80]; p = 0.66). Additionally, no significant difference was seen for implant failure at 3 months and functional outcomes at 12 months. Patients with immediate weight-bearing had shorter time to full weight-bearing (mean [SD], 87.6 days [7.5] vs. 121.3 days [11.0]; mean difference, −33.7 [95% CI, −35.0 to −32.3]; p < 0.001). Conclusions: Among older patients with intertrochanteric fractures, receipt of immediate weight-bearing as tolerated did not increase risks of implant failure or worsen functional outcomes compared with receipt of restricted weight-bearing. However, patients receiving immediate weight-bearing had a shorter time to full weight-bearing. Frontiers Media S.A. 2021-12-20 /pmc/articles/PMC8720847/ /pubmed/34988100 http://dx.doi.org/10.3389/fmed.2021.795595 Text en Copyright © 2021 Jia, Qiang, Zhang, Han, Wu and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Jia, Xiaoyang Qiang, Minfei Zhang, Kun Han, Qinghui Wu, Ying Chen, Yanxi Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title | Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title_full | Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title_fullStr | Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title_full_unstemmed | Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title_short | Influence of Timing of Postoperative Weight-Bearing on Implant Failure Rate Among Older Patients With Intertrochanteric Hip Fractures: A Propensity Score Matching Cohort Study |
title_sort | influence of timing of postoperative weight-bearing on implant failure rate among older patients with intertrochanteric hip fractures: a propensity score matching cohort study |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720847/ https://www.ncbi.nlm.nih.gov/pubmed/34988100 http://dx.doi.org/10.3389/fmed.2021.795595 |
work_keys_str_mv | AT jiaxiaoyang influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy AT qiangminfei influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy AT zhangkun influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy AT hanqinghui influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy AT wuying influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy AT chenyanxi influenceoftimingofpostoperativeweightbearingonimplantfailurerateamongolderpatientswithintertrochanterichipfracturesapropensityscorematchingcohortstudy |