The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Is Preoperative Bevacizumab Associated with Increased Complications After Urgent Hip Fracture Surgery? A Retrospective Review

Document Type : RESEARCH PAPER

Authors
Soheil Sabzevari 1
Bernadelle Boateng 1
Jessica A. Lavery 2
Meredith K. Bartelstein 1
1 Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
2 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
10.22038/abjs.2024.75222.3478
Abstract
Objectives: To investigate whether patients with impending or completed fracture of the proximal femur 
who were treated with bevacizumab in the six weeks prior to surgery are at higher risk of surgical 
complications than patients given bevacizumab outside of the six-week period.
Methods: We retrospectively reviewed cases of hip fracture treated between 1995 and 2020 at our institution. 
Patients were included if they were age 18 years or older, underwent hip surgery for impending or completed 
fracture, and received bevacizumab preoperatively but not postoperatively. Charts were reviewed for demographic, 
surgical, and postoperative details. A Cox model was applied to assess whether the timing of preoperative 
bevacizumab administration (≤6 weeks vs. >6 weeks) was associated with the risk of a postoperative complication.
Results: Two of the 23 patients who received bevacizumab ≤6 weeks before surgery experienced complications 
(deep vein thrombosis [n=1] and intraoperative fracture related to progression of disease [n=1]). Of the 53 patients 
who received bevacizumab more than six weeks preoperatively, five experienced complications (wound drainage 
[n=2] and deep vein thrombosis [n=3]). In the Cox model, timing of bevacizumab was not associated with 
postoperative complications (univariable hazard ratio, 0.92; 95% confidence interval, 0.18–4.73).
Conclusion: In this cohort of patients who underwent surgery for hip fractures, we did not observe an increased 
risk of postoperative complications among those who received bevacizumab within six weeks of surgery relative to 
those who received bevacizumab more than six weeks before surgery. The retrospective nature of the study and 
small sample size are limiting factors in this study.
 Level of evidence: III
Keywords
Bevacizumab
Hip fracture surgery
Wound complications
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 9
September 2024
Pages 645-651

  • Receive Date 28 September 2023
  • Revise Date 06 June 2024
  • Accept Date 15 May 2024