TY  - JOUR
T1  - DOES THE SEVERITY OF KNEE OSTEOARTHRITIS AFFECT THE TYPE OF PROXIMAL FEMUR FRACTURE IN THE ELDERLY POPULATION: A RETROSPECTIVE COHORT STUDY
TT  - DİZ OSTEOARTRİTİNİN ŞİDDETİ YAŞLI POPÜLASYONDA PROKSİMAL FEMUR KIRIĞI TİPİNİ ETKİLER Mİ: RETROSPEKTİF KOHORT ÇALIŞMASI
AU  - Polat, Ömer
AU  - Bulut, Halil İbrahim
AU  - Çamur, Savaş
AU  - Batıbay, Sefa Giray
PY  - 2025
DA  - July
Y2  - 2025
DO  - 10.18229/kocatepetip.1533019
JF  - Kocatepe Tıp Dergisi
JO  - KTD
PB  - Afyonkarahisar Sağlık Bilimleri Üniversitesi
WT  - DergiPark
SN  - 3061-9904
SP  - 220
EP  - 224
VL  - 26
IS  - 3
LA  - en
AB  - OBJECTIVE: Knee Osteoarthritis, a prevalent degenerative joint condition, poses a significant global burden, while proximal femur fractures are increasingly common among the geriatric population. Understanding the relationship between these entities remains crucial for effective clinical management. This study aims to investigate the association between knee osteoarthritis severity and the nature of proximal femur fractures in geriatric patients undergoing proximal femoral nailing for intertrochanteric femoral fractures.MATERIAL AND METHODS: A retrospective cohort study was conducted on 420 geriatric patients who underwent proximal femoral nailing (PFN) for femoral fracture between 2016 and 2021. Data on demographic characteristics, osteoarthritis severity (Kellgren-Lawrence classification), fracture type (AO/OTA classification), and clinical outcomes were collected. Statistical analysis was performed to evaluate the correlation of the hip fracture type with mild (Kellgren-Lawrence grades I/II) and severe (grades III/IV) knee osteoarthritis.RESULTS: Significant associations were observed between osteoarthritis severity and fracture type (p = 0.001). Patients with mild osteoarthritis predominantly exhibited AO/OTA type 1 fracture (74.7%), whereas those with severe osteoarthritis had a higher prevalence of AO/OTA type-2 (67.9%) and AO/OTA type 3 (18.6%) fractures. However, no significant difference was found in overall survival (p = 0.138) or revision rates (p = 0.978) between patients with mild and severe osteoarthritis.CONCLUSIONS: As the severity of osteoarthritis increased, the fracture type changed and was associated with a more comminuted fracture pattern.
KW  - Osteoarthritis
KW  - Knee
KW  - Femur
KW  - Fracture fixation
KW  - Intramedullary.
N2  - AMAÇ: Yaygın bir dejeneratif eklem rahatsızlığı olan Diz Osteoartriti, önemli bir küresel yük oluştururken, proksimal femur kırıkları geriatrik popülasyonda giderek daha yaygın hale geliyor. Bu durumlar arasındaki ilişkiyi anlamak, etkili klinik yönetim için hayati öneme sahip olmaya devam ediyor. Bu çalışma, intertrokanterik femoral kırıkları için proksimal femoral çivileme geçiren geriatrik hastalarda diz osteoartriti şiddeti ve proksimal femur kırıklarının doğası arasındaki ilişkiyi araştırmayı amaçlamaktadır.GEREÇ VE YÖNTEM: 2016-2021 yılları arasında femoral kırık nedeniyle proksimal femoral çivileme (PFN) uygulanan 420 geriatrik hastada retrospektif bir kohort çalışması yürütüldü. Demografik özellikler, osteoartrit şiddeti (Kellgren-Lawrence sınıflandırması), kırık türü (AO/OTA sınıflandırması) ve klinik sonuçlarla ilgili veriler toplandı. Kalça kırığı türünün hafif (Kellgren-Lawrence derece I/II) ve şiddetli (derece III/IV) diz osteoartriti ile korelasyonunu değerlendirmek için istatistiksel analiz yapıldı.BULGULAR: Osteoartrit şiddeti ile kırık tipi arasında anlamlı ilişkiler gözlemlendi (p = 0,001). Hafif osteoartritli hastalarda ağırlıklı olarak AO/OTA-tip 1 kırıkları (%74,7) görülürken, şiddetli osteoartritli hastalarda AO/OTA tip-2 (%67,9) ve AO/OTA tip 3 (%18,6) kırıklarının daha yüksek prevalansı vardı. Ancak, hafif ve şiddetli osteoartritli hastalar arasında genel sağ kalım (p = 0,138) veya revizyon oranlarında (p = 0,978) anlamlı bir fark bulunmadı.SONUÇ: Osteoartrit şiddeti artıkça kırık tipi değişti ve daha parçalı instabil kırık paterni ile birlikteliği görüldü.
CR  - 1. Cui A, Li H, Wang D et al. Global, regional prevalence, incidence, and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020;26:29–30:100587.
CR  - 2. Tokuda K, Anan M, Takahashi M et al. Biomechanical mechanism of lateral trunk lean gait for knee 
osteoarthritis patients. Journal of Biomechanics. 2018;3:66:10–7.
CR  - 3. Levinger P, Dunn J, Bifera N et al. High-speed resistance training and balance training for people with knee 
osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled trial. Trials. 2017;18(1):384.
CR  - 4. Zhang Y, Li X, Wang Y, et al. Association of knee and hip osteoarthritis with the risk of falls and fractures: a 
systematic review and meta-analysis. Arthritis Research & Therapy. 2023;25(1):184.
CR  - 5. Meinberg E, Agel J, Roberts C et al. Fracture and Dislocation Classification Compendium-2018. Journal of 
Orthopaedic Trauma. 2018;32(1):1-170.
CR  - 6. Kellgren JH, Lawrence JS. Radiological Assessment of Osteo-Arthrosis. Annals of the Rheumatic Diseases. 
1957;16(4):494-502.
CR  - 7. Walter N, Szymski D, Kurtz SM et al. Epidemiology and treatment of proximal femoral fractures in the elderly 
U.S. population. Scientific Reports. 2023;13(1):12734.
CR  - 8. Tiwari N, Patil S, Popalbhat R. Efficacy of Physiotherapy Rehabilitation for Proximal Femur Fracture. Cureus. 
2022;26;14(10):e30711.
CR  - 9. Carneiro MB, Alves DPL, Mercadante MT. Physical therapy in the postoperative of proximal femur fracture in 
elderly. Literature review. Acta Ortopédica Brasileira. 2013;21(3):175-8.
CR  - 10. Rai B, Singh J, Singh V, et al. Evaluation of the Outcomes of Proximal Femoral Nail Antirotation II in the 
Treatment of Trochanteric Fracture in Elderly Patients. Cureus. 2022;10;14(5):e24896.
CR  - 11. Witham MD, Dodds RM. Hip fracture and sarcopenia: the need for a new paradigm in drug trials for older 
adults? Lancet Healthy Longev. 2021;2(5):234-5.
CR  - 12. Atik OŞ. There is an association between sarcopenia, osteoporosis, and the risk of hip fracture. Eklem Hastalik 
Cerrahisi. 2019;30(1):1.
CR  - 13. Fischer H, Maleitzke T, Eder C et al. Management of proximal femur fractures in the elderly: current concepts 
and treatment options. European Journal of Medical Research. 2021;26(1):86.
CR  - 14. Kumar P, Rajnish RK, Sharma S et al. Proximal femoral nailing is superior to hemiarthroplasty in AO/OTA A2 
and A3 intertrochanteric femur fractures in the elderly: a systematic literature review and meta-analysis. 
International Orthopaedics. 2020;44(4):623-33.
CR  - 15. Ekinci Y. A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal 
femoral nailing. Joint Diseases and Related Surgery. 2020;31(2):209-17.
CR  - 16. Bacaksiz T, Akan I. The Fate of Reoperation After Proximal Femur Fracture Surgery in Elderly Population. 
Cureus. 2023;2;15(6):e39856.
UR  - https://doi.org/10.18229/kocatepetip.1533019
L1  - https://dergipark.org.tr/en/download/article-file/4144135
ER  -