Periprosthetic femoral fractures: data, management and outcomes

• Research type

  Research Study

• Full title

  Periprosthetic femoral fractures: data, management and outcomes

• IRAS ID

  323767

• Contact name

  Alex Bottle

• Contact email

  robert.bottle@imperial.ac.uk

• Duration of Study in the UK

  3 years, 0 months, 0 days

• Research summary

  Hip and knee joint replacements are common operations and, due to an ageing and increasingly frail population, are forecast to increase greatly in the coming years. A recognised complication of these procedures is periprosthetic femoral fracture (PPFF), when the bone around the prosthesis breaks. As numbers of joint replacements rise, numbers of PPFFs will also rise. Hospital stays are often long, with high costs, and outcomes can be poor. Regional and local differences exist in both how to manage these patients and in their outcomes, though progress is limited due to a shortage of concrete data on approaches to management, processes and outcomes. There is also uncertainty over which service model(s) is considered best by healthcare staff and patients.

  This project aims to fill these key gaps through a mixed-methods study consisting of secondary data analysis and new qualitative case studies, with three work packages (WPs). Our objectives are to:
  1. Assess the variation between hospitals in England in how these patients are managed and their outcomes
  2. Obtain healthcare professionals’ views on how patients should be managed, collecting new qualitative data from interviews and service case studies
  3. Obtain patients’, family members’ and carers’ views on what they want from care before, during and after fracture treatment, including, for instance, on whether they would be willing to travel to a specialised centre
  4. Define measures of quality of care to assess future improvement efforts and explore the best way to collect any necessary additional data for these measures

  With Section 251 support, WP1 will use four existing databases. Predictors of outcomes and variations in processes and outcomes between hospitals and service models will be estimated through statistical models and plots. Casenote reviews by hospital staff will assess database accuracy. This ethics application covers only WP1, the quantitative analysis.

• REC name

  London - South East Research Ethics Committee

• REC reference

  23/LO/0196

• Date of REC Opinion

  9 Mar 2023

• REC opinion

  Favourable Opinion