Description
In this presentation, Jonathan Evans, a clinical academic and hip surgeon based in Exeter, discusses recent findings surrounding periprosthetic fractures in total hip replacements. He addresses his roles and potential conflicts of interest while expressing transparency in his involvement with Stryker, emphasizing that collaboration has been crucial for the project. He recounts a controversial presentation earlier in the year at the British Hip Society, where his evidence on periprosthetic fractures prompted discussions and concerns over the Exeter hip stem.
Evans pioneers into data analysis linking the National Joint Registry to hospital coding from 2004 to 2020, revealing an overlooked segment of patients who experienced fractures treated conservatively rather than through revision surgeries. He highlights a troubling trend of increasing periprosthetic fractures and examines their incidence rates across various timelines post-surgery. His analysis reveals 30-day and one-year mortality rates for these fractures comparable to hip fractures, underscoring the significant impact on patient outcomes and the healthcare system through lengthy hospital stays and associated costs.
The presentation culminates in a discussion about effective patient management strategies and the ongoing evolution in surgical approaches for addressing periprosthetic fractures. He promotes adherence to guidelines suggesting timely surgical interventions within 48 hours, encouraging auditing practices among hospitals. Evans assures attendees that there is still value in using the Exeter hip stem while also advocating for a balanced approach to patient care that prioritizes outcomes over the specific types of implants used. He concludes by acknowledging funding from Orthopedic Research UK and expresses gratitude toward collaborative efforts in advancing the understanding and treatment of periprosthetic fractures.