Risk predictors of contralateral refracture after artificial joint replacement for hip frature:using PSM method

HE Xinzhuang; LI Shaohua

doi:10.3969/j.issn.1674-666X.2025.01.004

Abstract：Objective To investigate the risk predictors of contralateral refracture after artificial hip replacement(AHR)for hip fracture(HF)using propensity score matching(PSM)method.Methods An analysis was performed on the clinical data of HF patients who underwent AHR in Yongmei Group General Hospital from March 2016 to March 2021.Patients were divided into a refracture group and a non-refracture group based on whether contralateral hip refracture occurred within 3 years postoperatively.The PSM method was used to perform 1∶1 matching of the two groups for sex,age,body mass index,history of hypertension or diabetes,and initial fracture type.Clinical data of the two groups after matching were compared,and multivariate Logistic regression analysis was used to explore the risk factors for contralateral hip refracture after AHR for HF patients.Results Among 436 HF patients,61(13.99%)developed contralateral hip refracture postoperatively.After PSM,57 pairs of patients were successfully matched in the refracture and non-refracture groups.The refracture group had a higher proportion of osteoporosis,visual impairment,rheumatoid arthritis,chronic obstructive pulmonary disease(COPD),Singh index≤grade Ⅲ,and poor exercise compliance,and longer postoperative bed rest duration compared with the non-refracture group(P<0.05).The results of multivariate Logistic regression analysis also showed that these several indicators were risk factors for contralateral hip refracture after AHR for HF patients(all P<0.05).Conclusion After balancing confounding factors in baseline materials by PSM,osteoporosis,visual impairment,rheumatoid arthritis,Singh index≤grade Ⅲ,poor exercise compliance,and long postoperative bed rest duration are risk factors for contralateral hip refracture after AHR for HF patients.