Evaluating the Relationship between Intertrochanteric Fracture Complexity and Knee Osteoarthritis Severity in Elderly Patients: A Quantitative Analysis

Abstract

Intertrochanteric fractures and knee osteoarthritis are prevalent among elderly patients; however, the relationship between the complexity of these fractures and the severity of knee osteoarthritis remains poorly understood. This study aimed to investigate the correlation between the complexity of intertrochanteric fractures and the severity of knee osteoarthritis in elderly patients. A total of 130 elderly patients with knee osteoarthritis, admitted between February 2021 and June 2023, were divided into a non-fracture group (77 patients) and a fracture group (53 patients). The fracture group was further stratified into a simple fracture subgroup (23 cases) and a complex fracture subgroup (30 cases). The Hospital for Special Surgery (HSS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Kellgren-Lawrence (K-L) grade were compared across the groups. Pearson correlation analysis was employed to assess the relationship between these variables and fracture complexity. Results revealed that the non-fracture group exhibited significantly higher HSS scores (64.88 ± 9.87 vs. 57.36 ± 10.08) and a greater proportion of mild K-L grade cases (80.52% vs. 20.75%) compared to the fracture group. Conversely, the fracture group demonstrated higher WOMAC scores (35.67 ± 8.19 vs. 43.22 ± 10.77) and a higher proportion of severe K-L grade cases (19.48% vs. 79.25%). Within the fracture group, the simple fracture subgroup had higher HSS scores (63.14 ± 9.27 vs. 55.43 ± 9.54) and lower WOMAC scores and severe K-L grade proportions compared to the complex fracture subgroup. HSS scores were negatively correlated with fracture occurrence (r = -0.351), while WOMAC scores and K-L grades were positively correlated with fracture complexity (r = 0.372, 0.592). These findings suggest a positive correlation between the complexity of intertrochanteric fractures and the severity of knee osteoarthritis, indicating that more severe osteoarthritis may be predictive of more complex fractures.