AB158. SOH26AB_0198. The acute healthcare burden of periprosthetic fractures: a retrospective, single-centre study

Background: Periprosthetic fractures (PPFs) are complex requiring specialist input and increased resources. Patients are frail and comorbid, similar to hip fracture patients. We hypothesize that although these patients are treated in accordance with Irish Hip Fracture Database (IHFD) neck of femur fracture guidelines, they require longer operations, more complex surgery, and require intensive care unit (ICU) stay more. As such, we aimed to compare the peri- and postoperative outcomes of PPF to hip fractures for assessment of resources.

Methods: Retrospective study of PPF treated in our centre between January 2022 and June 2024, matched with a 2:1 ratio to hip fractures between January 2024 and June 2024. Demographics recoded included age, sex, fracture pattern, American Society of Anaesthesiologists (ASA) grade, and frailty scale. Statistical analyses performed using GraphPad Prism Software V10 for Mac.

Results: Analysis included 45 PPFs and 90 hip fractures. No significant difference in mean age (P=0.49), sex (P=0.15), or length of stay (P=0.67). PPF patients were generally less frail than hip fracture patients (P=0.009). ASA score was not significantly different between the two groups (P=0.15). Mean amount of time patients waited for their operation was increased in the PPF group by 1.75 days. Mean operative time was longer in the PPF group (P<0.001). Significantly more PPFs required critical care post-operatively (P=0.04).

Conclusions: PPF, when compared to hip fractures, utilised more resources in terms of operative time and critical care beds. Additionally, they require specialist arthroplasty surgeon management. As such, additional resources should be allocated to centres performing a large volume of PPF cases.

Keywords: Trauma; orthopaedics; periprosthetic fractures (PPFs); hip fractures; perioperative care