Description
Analysis of incidence and risk factor for periprosthetic fracture after total knee arthroplasty in Korea between 2010 and 2020 based on national registry
Background : With the increased use of total knee arthroplasty (TKA), socioeconomic burden of periprosthetic fracture (PPF) which is one of the major complication after TKA is also rapidly increasing. However, the study that analyze the epidemiology of PPF after TKA based on national registry is very limited..
Purpose : This study aimed to (1) document the incidence of PPF after TKA in Korea between 2010 and 2020 based on the national registry data, and (2) analyze the risk factor PPF after TKA.
Materials and Methods : Using the Health Insurance Review and Assessment Korean database, the annual incidence of PPF after TKA in Korea between 2010 and 2020 were evaluated, and stratified by age and gender. The PPF rate was defined as total PPF patients per total TKA patients. Medical comorbidities including coronary heart disease, cerebrovascular disease, pulmonary disease, dementia, peptic ulcer, liver disease, diabetes, hemiplegia, renal disease, cancer, Parkinson disease, and osteoporosis were evaluated as possible risk factors for PPF using the cox hazards ratio (HR).
Results : Overally, 2.37% of TKA patients (14,429 PPF / 608,605 TKAs) experienced PPF between 2010 and 2020 in Korea. The PPF rate was similar between different age groups, and female patients showed higher PPF rate compare to male patients. Cox hazard model identified severe liver disease (HR 1.303; CI, 1.015-1.674), hemiplegia (HR 1.244; CI, 1.021-1.515), dementia (HR 1.206; CI, 1.118-1.301), Diabetes (HR 1.181; CI, 1.141-1.221), renal disease (HR 1.159; CI, 1.057-1.270), cerebrovascular diseaseas (HR 1.148; CI, 1.099-1.201), osteoporosis (HR 1.101; CI, 1.064-1.142) as risk factors for PPF after TKA.
Conclusion
Between 2010 and 2020, overall PPF rate after TKA were 2.37% in korea, and annual PPF incidence gradually increased. Severe liver disease, hemiplegia, and dementia were identified as strong risk factors for PPF after TKA. The results of this study shows necessity of appropriate health care strategy to prevent and reduce PPF after TKA, especially in high risk group.
