Periprosthetic fractures after hip and knee arthroplasty in France

Listen to Simon and Amy discuss the paper 'Periprosthetic fractures after hip and knee arthroplasty in France: national trends and future projections' published in the July 2026 issue of Bone & Joint Open.

Click here to read the paper.

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Transcript

[00:00:00] Welcome back to another episode of AI Talks with Bone & Joint from the publishers of Bone & Joint Open. Today, we're discussing the paper, 'Periprosthetic fractures after hip and knee arthroplasty in France: national trends and future projections', published in July 2026 by B D Geofroy and colleagues. I'm Simon and I'm joined by my co-host Amy.

Hello everyone. This interesting paper offers a thorough nationwide assessment of periprosthetic fractures post hip and knee arthroplasty in France over the past decade and projects the future burden up to 2070.

With the increasing number of hip and knee arthroplasties in aging populations, the incidence of periprosthetic fractures is also rising. These fractures come with heightened morbidity and mortality making their study essential for enhancing patient outcomes and healthcare planning. The researchers aimed to quantify national trends in the incidence of these fractures in France, assess short and midterm mortality rates, identify risk factors and project the future burden [00:01:00] using various epidemiological scenarios.

They utilized data from the French National Health Data System covering nearly the entire French population. The retrospective nationwide cohort study spanned January 2015 to December 2024. They included all patients who underwent reoperation for hip or knee periprosthetic fracture in France and calculated annual incidence rates per 100,000 inhabitants. Projections for 2030 to 2070 were made using static and dynamic models.

Over this 10-year period, the incidence of periprosthetic fractures doubled rising from 1.73 to 3.94 per 100,000 inhabitants. They identified 15,029 periprosthetic fractures with an average age of 81 years and 70% of the patients were female.

The mortality rates were notable as well, 8% at three months and 16% at one year. Older age and higher comorbidity burden were major prognostic factors for mortality. For [00:02:00] example, each additional year of age increased the three-month risk of death by 10% and the one-year risk by 8.5%. Yes, and postoperative complications occurred in 16% of patients within three months, including pressure ulcers and cardiovascular events. The dynamic model projections were quite concerning, suggesting up to a 248% increase in periprosthetic fractures by 2070.

The study's findings highlight the importance of optimising perioperative and post-fracture care, as well as implementing measures to prevent fractures and related complications.

This is crucial given the projected rise in cases, which will significantly strain healthcare resources. The researchers stressed the need for multidisciplinary geriatric care and targeted prevention strategies such as osteoporosis screening and fall risk assessment to reduce the impact of these fractures. They also noted the importance of anticipating surgical capacity and rehabilitation needs.

This study not only offers valuable insights into the current situation [00:03:00] but also prepares the orthopaedic community for future challenges. It's a call to action for healthcare providers and policymakers to start planning now for the expected increase in periprosthetic fractures.

Absolutely, Simon. To sum up, the key takeaways from this study are the rising incidence of periprosthetic fractures due to an aging population and increasing arthroplasty rates, the high early morbidity and mortality associated with these fractures, and the need for proactive measures to optimise patient outcomes and manage future healthcare demands.

Thank you for tuning in to this episode of AI Talks with Bone & Joint. Don't forget to check out the full paper for more detailed information. Until next time, take care.