{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:02:36Z","timestamp":1781625756658,"version":"3.54.5"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periprosthetic femoral fractures (PPF) following total hip arthroplasty (THA) are a growing clinical challenge, particularly in the elderly. Postoperative mobility is a key determinant of outcome, yet little is known about how surgical treatment and weight-bearing protocols influence functional recovery in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 186 patients aged\u2009\u2265\u200965 years treated surgically for Vancouver type B or C PPF between January 2017 and August 2023 at a level 1 trauma center. Patients underwent either open reduction and internal fixation (ORIF) or revision arthroplasty. Postoperative weight-bearing protocols were categorized as full weight bearing (FWB) or partial weight bearing (PWB). The primary outcome was mobility status at hospital discharge. Binary logistic regression was used to identify independent risk factors for immobility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 186 patients included (mean age 82.4\u2009\u00b1\u20097.4 years), 64.5% were mobilized with FWB. In the ORIF group, patients allowed FWB were significantly older (85.5\u2009\u00b1\u20097.4 vs. 80.2\u2009\u00b1\u20096.3 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No significant differences in mobility, complication rates, revision surgery, or in-hospital mortality were observed between weight-bearing regimens, regardless of the type of surgery. Logistic regression identified intraoperative blood transfusion (OR\u2009=\u20093.17) and higher ASA scores (ASA III: OR\u2009=\u20099.10; ASA IV: OR\u2009=\u200932.03) as independent predictors of postoperative immobility. Neither the postoperative weight-bearing protocol nor the surgical procedure had a significant impact on mobility outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study examines postoperative weight-bearing strategies on clinical outcomes in patients with periprosthetic hip fractures and simultaneously identifies independent risk factors associated with postoperative immobility. Our findings suggest that mobility outcomes are more influenced by patient-related factors than by surgical procedure. Our findings support the safe implementation of full weight-bearing protocols in elderly patients following periprosthetic femoral fractures, regardless of the type of surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-06145-8","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T10:14:05Z","timestamp":1764670445000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of immobility following surgery for periprosthetic hip fractures"],"prefix":"10.1007","volume":"145","author":[{"given":"Christopher","family":"Lampert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Pachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Pfahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris Michael","family":"Holzapfel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"B\u00f6cker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Helfen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Neuerburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Faust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"6145_CR1","doi-asserted-by":"crossref","unstructured":"The COMPOSE Study Team (2022) Management and outcomes of femoral periprosthetic fractures at the hip: data from the characteristics, outcomes and management of periprosthetic fracture service evaluation (COMPOSE) cohort study. Bone Joint J, 104\u2013b(8):997\u20131008","DOI":"10.1302\/0301-620X.104B8.BJJ-2021-1682.R1"},{"issue":"2","key":"6145_CR2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/S0030-5898(05)70076-6","volume":"30","author":"OH Brady","year":"1999","unstructured":"Brady OH, Garbuz DS, Masri BA, Duncan CP (1999) Classification of the hip. Orthop Clin North Am 30(2):215\u2013220","journal-title":"Orthop Clin North Am"},{"issue":"8","key":"6145_CR3","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1007\/s00264-017-3481-7","volume":"41","author":"BJ Braun","year":"2017","unstructured":"Braun BJ, Veith NT, Rollmann M et al (2017) Weight-bearing recommendations after operative fracture treatment-fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole. Int Orthop 41(8):1507\u20131512","journal-title":"Int Orthop"},{"issue":"1","key":"6145_CR4","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1111\/jep.12645","volume":"24","author":"L Carlin","year":"2018","unstructured":"Carlin L, Sibley K, Jenkinson R et al (2018) Exploring Canadian surgeons\u2019 decisions about postoperative weight bearing for their hip fracture patients. J Eval Clin Pract 24(1):42\u201347","journal-title":"J Eval Clin Pract"},{"issue":"4","key":"6145_CR5","doi-asserted-by":"publisher","first-page":"402","DOI":"10.5312\/wjo.v5.i4.402","volume":"5","author":"P Carpintero","year":"2014","unstructured":"Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M (2014) Complications of hip fractures: a review. World J Orthop 5(4):402\u2013411","journal-title":"World J Orthop"},{"issue":"9s2","key":"6145_CR6","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.1016\/j.arth.2024.04.037","volume":"39","author":"EB Gausden","year":"2024","unstructured":"Gausden EB, Bedard NA, Gililland JM, Haidukewych GJ (2024) What\u2019s new in periprosthetic femur fractures? J Arthroplasty 39(9s2):S18-s25","journal-title":"J Arthroplasty"},{"issue":"1","key":"6145_CR7","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s00068-022-02032-8","volume":"49","author":"D Gonz\u00e1lez-Mart\u00edn","year":"2023","unstructured":"Gonz\u00e1lez-Mart\u00edn D, Hern\u00e1ndez-Castillejo LE, Herrera-P\u00e9rez M, Pais-Brito JL, Gonz\u00e1lez-Casamayor S, Garrido-Miguel M (2023) Osteosynthesis versus revision arthroplasty in Vancouver B2 periprosthetic hip fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg 49(1):87\u2013106","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"23","key":"6145_CR8","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.2106\/JBJS.N.00077","volume":"96","author":"A Hart","year":"2014","unstructured":"Hart A, Khalil JA, Carli A, Huk O, Zukor D, Antoniou J (2014) Blood transfusion in primary total hip and knee arthroplasty. Incidence, risk factors, and thirty-day complication rates. J Bone Joint Surg Am 96(23):1945\u20131951","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"6145_CR9","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1016\/j.arth.2018.01.046","volume":"33","author":"BD Haughom","year":"2018","unstructured":"Haughom BD, Basques BA, Hellman MD, Brown NM, Della Valle CJ, Levine BR (2018) Do mortality and complication rates differ between periprosthetic and native hip fractures? J Arthroplasty 33(6):1914\u20131918","journal-title":"J Arthroplasty"},{"issue":"6_Supple_B","key":"6145_CR10","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1302\/0301-620X.101B6.BJJ-2018-1376.R1","volume":"101-b","author":"JT Hines","year":"2019","unstructured":"Hines JT, Hernandez NM, Amundson AW, Pagnano MW, Sierra RJ, Abdel MP (2019) Intravenous tranexamic acid safely and effectively reduces transfusion rates in revision total hip arthroplasty. Bone Joint J 101-b(6_Supple_B):104\u2013109","journal-title":"Bone Joint J"},{"issue":"5","key":"6145_CR11","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1046\/j.1365-2702.2002.00646.x","volume":"11","author":"I Johansson","year":"2002","unstructured":"Johansson I, Athlin E, Frykholm L, Bolinder H, Larsson G (2002) Intermittent versus indwelling catheters for older patients with hip fractures. J Clin Nurs 11(5):651\u2013656","journal-title":"J Clin Nurs"},{"issue":"11","key":"6145_CR12","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1093\/gerona\/58.11.M1042","volume":"58","author":"HK Kamel","year":"2003","unstructured":"Kamel HK, Iqbal MA, Mogallapu R, Maas D, Hoffmann RG (2003) Time to ambulation after hip fracture surgery: relation to hospitalization outcomes. J Gerontol Biol Sci Med Sci 58(11):1042\u20131045","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"11","key":"6145_CR13","doi-asserted-by":"publisher","first-page":"936","DOI":"10.2106\/JBJS.17.01222","volume":"100","author":"C Kammerlander","year":"2018","unstructured":"Kammerlander C, Pfeufer D, Lisitano LA, Mehaffey S, B\u00f6cker W, Neuerburg C (2018) Inability of older adult patients with hip fracture to maintain postoperative Weight-Bearing restrictions. J Bone Joint Surg Am 100(11):936\u2013941","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"6145_CR14","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.arth.2016.08.026","volume":"32","author":"JL Kim","year":"2017","unstructured":"Kim JL, Park JH, Han SB, Cho IY, Jang KM (2017) Allogeneic blood transfusion is a significant risk factor for Surgical-Site infection following total hip and knee arthroplasty: a meta-analysis. J Arthroplasty 32(1):320\u2013325","journal-title":"J Arthroplasty"},{"issue":"2","key":"6145_CR15","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.arth.2021.09.006","volume":"37","author":"JN Lamb","year":"2022","unstructured":"Lamb JN, Nix O, Al-Wizni A, West R, Pandit H (2022) Mortality after postoperative periprosthetic fracture of the femur after hip arthroplasty in the last decade: meta-analysis of 35 cohort studies including 4841 patients. J Arthroplasty 37(2):398-405.e391","journal-title":"J Arthroplasty"},{"key":"6145_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13216475","author":"C Lampert","year":"2024","unstructured":"Lampert C, Linhart C, Holzapfel BM, B\u00f6cker W, Neuerburg C, Zhang Y (2024) Open reduction and internal fixation is a feasible alternative to femoral revision arthroplasty in geriatric patients with Vancouver B2\/3 type periprosthetic fractures: a study analyzing in-hospital outcomes. J Clin Med. https:\/\/doi.org\/10.3390\/jcm13216475","journal-title":"J Clin Med"},{"issue":"6","key":"6145_CR17","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1111\/j.1532-5415.2000.tb04718.x","volume":"48","author":"ER Marcantonio","year":"2000","unstructured":"Marcantonio ER, Flacker JM, Michaels M, Resnick NM (2000) Delirium is independently associated with poor functional recovery after hip fracture. J Am Geriatr Soc 48(6):618\u2013624","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"6145_CR18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1177\/2151458512463392","volume":"3","author":"IB Menzies","year":"2012","unstructured":"Menzies IB, Mendelson DA, Kates SL, Friedman SM (2012) The impact of comorbidity on perioperative outcomes of hip fractures in a geriatric fracture model. Geriatr Orthop Surg Rehabil 3(3):129\u2013134","journal-title":"Geriatr Orthop Surg Rehabil"},{"issue":"11","key":"6145_CR19","doi-asserted-by":"publisher","first-page":"2185","DOI":"10.1007\/s00198-021-05956-w","volume":"32","author":"AC Meyer","year":"2021","unstructured":"Meyer AC, Eklund H, Hedstr\u00f6m M, Modig K (2021) The ASA score predicts infections, cardiovascular complications, and hospital readmissions after hip fracture - a nationwide cohort study. Osteoporos Int 32(11):2185\u20132192","journal-title":"Osteoporos Int"},{"issue":"10","key":"6145_CR20","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1302\/0301-620X.100B10.BJJ-2018-0489.R1","volume":"100-b","author":"TD Ottesen","year":"2018","unstructured":"Ottesen TD, McLynn RP, Galivanche AR et al (2018) Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients. Bone Joint J 100-b(10):1377\u20131384","journal-title":"Bone Joint J"},{"issue":"8","key":"6145_CR21","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1302\/0301-620X.97B8.35170","volume":"97-b","author":"A Patel","year":"2015","unstructured":"Patel A, Pavlou G, M\u00fajica-Mota RE, Toms AD (2015) The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J 97-b(8):1076\u20131081","journal-title":"Bone Joint J"},{"issue":"9","key":"6145_CR22","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1007\/s00402-019-03193-9","volume":"139","author":"D Pfeufer","year":"2019","unstructured":"Pfeufer D, Zeller A, Mehaffey S, B\u00f6cker W, Kammerlander C, Neuerburg C (2019) Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients. Arch Orthop Trauma Surg 139(9):1253\u20131259","journal-title":"Arch Orthop Trauma Surg"},{"key":"6145_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2022.101925","volume":"31","author":"RD Richard","year":"2022","unstructured":"Richard RD, Gaski GE, Farooq H, Wagner DJ, McKinley TO, Natoli RM (2022) Risk factors for complications within 30 days of operatively fixed periprosthetic femur fractures. J Clin Orthop Trauma 31:101925","journal-title":"J Clin Orthop Trauma"},{"issue":"8","key":"6145_CR24","doi-asserted-by":"publisher","first-page":"e0182920","DOI":"10.1371\/journal.pone.0182920","volume":"12","author":"J Shafrin","year":"2017","unstructured":"Shafrin J, Sullivan J, Goldman DP, Gill TM (2017) The association between observed mobility and quality of life in the near elderly. PLoS One 12(8):e0182920","journal-title":"PLoS One"},{"issue":"8","key":"6145_CR25","doi-asserted-by":"publisher","first-page":"482","DOI":"10.5435\/JAAOS-22-08-482","volume":"22","author":"RP Shah","year":"2014","unstructured":"Shah RP, Sheth NP, Gray C, Alosh H, Garino JP (2014) Periprosthetic fractures around loose femoral components. J Am Acad Orthop Surg 22(8):482\u2013490","journal-title":"J Am Acad Orthop Surg"},{"issue":"2","key":"6145_CR26","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1093\/ageing\/afaa204","volume":"50","author":"KJ Sheehan","year":"2021","unstructured":"Sheehan KJ, Goubar A, Almilaji O et al (2021) Discharge after hip fracture surgery by mobilisation timing: secondary analysis of the UK National Hip Fracture Database. Age Ageing 50(2):415\u2013422","journal-title":"Age Ageing"},{"issue":"2","key":"6145_CR27","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/s11606-016-3848-2","volume":"32","author":"VL Tang","year":"2017","unstructured":"Tang VL, Sudore R, Cenzer IS et al (2017) Rates of recovery to pre-fracture function in older persons with hip fracture: an observational study. J Gen Intern Med 32(2):153\u2013158","journal-title":"J Gen Intern Med"},{"issue":"4","key":"6145_CR28","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1177\/2151458512473827","volume":"3","author":"C Ulucay","year":"2012","unstructured":"Ulucay C, Eren Z, Kaspar EC et al (2012) Risk factors for acute kidney injury after hip fracture surgery in the elderly individuals. Geriatr Orthop Surg Rehabil 3(4):150\u2013156","journal-title":"Geriatr Orthop Surg Rehabil"},{"issue":"2","key":"6145_CR29","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/j.1447-0594.2012.00904.x","volume":"13","author":"AJ Vochteloo","year":"2013","unstructured":"Vochteloo AJ, Moerman S, Tuinebreijer WE et al (2013) More than half of hip fracture patients do not regain mobility in the first postoperative year. Geriatr Gerontol Int 13(2):334\u2013341","journal-title":"Geriatr Gerontol Int"},{"issue":"1","key":"6145_CR30","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/j.1365-2753.2008.00943.x","volume":"15","author":"J Wu","year":"2009","unstructured":"Wu J, Kurrle S, Cameron ID (2009) Restricted weight bearing after hip fracture surgery in the elderly: economic costs and health outcomes. J Eval Clin Pract 15(1):217\u2013219","journal-title":"J Eval Clin Pract"},{"issue":"11","key":"6145_CR31","doi-asserted-by":"publisher","first-page":"2548","DOI":"10.1016\/j.arth.2016.03.059","volume":"31","author":"YG Wu","year":"2016","unstructured":"Wu YG, Zeng Y, Yang TM, Si HB, Cao F, Shen B (2016) The efficacy and safety of combination of intravenous and topical tranexamic acid in revision hip arthroplasty: a randomized, controlled trial. J Arthroplasty 31(11):2548\u20132553","journal-title":"J Arthroplasty"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06145-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-025-06145-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06145-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:53:47Z","timestamp":1781621627000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-025-06145-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6145"],"URL":"https:\/\/doi.org\/10.1007\/s00402-025-06145-8","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]},"assertion":[{"value":"17 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"523"}}