Clinical trial NCT06428760: Relationship Between Preoperative Subcutaneous Trochanteric Fat Thickness and Postoperative Infection Risk
Official title: The Effect of Preoperative Subcutaneous Trochanteric Fat Thickness and Trochanteric Soft Tissue Thickness on Postoperative Infection Risk in Patients Undergoing Hemiarthroplasty for Femoral Neck Fracture
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Hip Infection
Keywords: subcutaneous trochanteric fat thickness
infection
femoral neck fracture
soft tissue thickness
obesity
hemiarthroplasty
Lead sponsor: Ankara City Hospital Bilkent
Sponsor class: OTHER
First posted: 2024-05-24
Enrollment: 80
Sex: FEMALE
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Female patients over 65 years of age who were admitted to our hospital with a history of a femoral neck fracture and who underwent hemiarthroplasty.

Brief summary: The effect of preoperative subcutaneous trochanteric fat thickness and trochanteric soft tissue thickness on postoperative infection risk in patients undergoing hemiarthroplasty for femoral neck fracture

Detailed description: Obesity is a growing problem for healthcare systems and orthopaedic surgeons, with 29% of the adult population in the UK and 40% in the US affected by obesity. The most commonly used measure of obesity in healthcare is body mass index (BMI), and the World Health Organisation defines obesity as a BMI ≥ 30 kg/m2. Much of the arthroplasty literature has also focused on the use of BMI as a measure of obesity.

BMI-defined obesity is associated with an increased risk of perioperative complications (including infection and dislocation) in total hip arthroplasty. It has also been shown that there is a gradual increase in anaesthetic time, operative time and length of hospital stay as BMI increases in obese patients.

BMI is an imperfect measure because it does not take into account age, sex, race, fat distribution or muscle mass. Previous studies have shown that subcutaneous fat depth (FD) is an independent risk factor for wound infection in cervical and lumbar spine surgery and after laparotomy. It is not known whether increased subcutaneous fat and soft tissue mass are associated with an increased risk of complications after arthroplasty for femoral neck fractures.

The aim of this study was to investigate whether preoperative measurement of subcutaneous adipose tissue by radiography and computed tomography (CT) and muscle thickness in the gluteus medius/minus, gluteus maximus, anterior and medial compartments by computed tomography (CT) in femoral neck fractures correlate with infection rates at postoperative follow-up.

Hypothesis: In patients with high body mass index (BMI) with femoral neck fractures, the investigators believe that the relationship between increased subcutaneous adipose tissue on radiographs and CT sections and wound infection is as effective as the relationship between increased muscle thickness in the gluteus medius/minimus, gluteus maximus, anterior and medial compartments measured on CT sections and wound infection.

Eligibility criteria: Inclusion Criteria:

* Patients over 65 years of age
* Femoral neck fractures
* Female patients
* Patients undergoing hemiarthroplasty

Exclusion Criteria:

* Patients younger than 65 years
* Male patients
* Patients with immunosuppressive conditions
* Intertrochanteric fractures
* Patients with revision surgery
* Pathological femoral neck fractures

Primary outcomes:
measure: Effect of trochanteric fat and soft tissue
timeFrame: Pre-operative
measure: Wound infection
timeFrame: First 3 months after surgery
Secondary outcomes:
measure: Hospital Length of Stay (LOS)
timeFrame: 1 months
measure: Mortality Rate
timeFrame: 6 months
measure: Body Mass Index
timeFrame: Measured once preoperatively
measure: Biochemistry Scans
timeFrame: 1 months
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara Bilkent City Hospital
state: Cankaya
Study officials:
References: