Incidence, Classification, and Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients Undergoing Total Hip Arthroplasty With a Single Stem: A Retrospective Study
Incidence, Classification, and Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients Undergoing Total Hip Arthroplasty With a Single Stem: A Retrospective Study
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DOI：
10.1016/j.arth.2019.03.031
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发表时间：
2019-07-01
影响因子：
3.5
通讯作者：
Han, Yongtai
中科院分区：
文献类型：
--
作者：
Liu, Bo;Ma, Wenhui;Han, Yongtai
背景：保留股骨颈（CFP）柄是一种专门设计的股骨颈保留组件。这种特殊柄的术中假体周围股骨骨折的发生率、分类和危险因素仍不清楚。方法：这是一项回顾性研究。我们分析了 2006 年 1 月至 2018 年 11 月期间在我院接受 CFP 柄初次髋关节置换术的所有患者的临床和放射学数据。人口统计学特征和放射学特征分别从病历和图片存档和通信系统中获得。确定了术中假体周围股骨骨折的发生率、温哥华分型和危险因素。结果：总共纳入 1633 个髋关节。接受CFP柄全髋关节置换术的患者假体周围股骨骨折的发生率为3.2%。根据温哥华分型，温哥华A型骨折24例（45.3%），温哥华B型骨折27例（50.9%），温哥华C型骨折2例（3.8%）。发现了五个独立的风险（保护性）因素，包括手术史（比值比 [OR] = 3.275，95% 置信区间 [CI] = 1.192-8.997）、颈干角度（OR = 1.104，95% CI = 1.058-1.152）、保留颈长度（OR = 0.913，95% CI = 0.850-0.980）、管扩张指数（OR = 0.636，95% CI = 0.413-0.980）和骨密度（OR = 0.083，95% CI = 0.016-0.417）。结论：本研究确定了接受 CFP 柄的患者术中假体周围股骨骨折的详细特征。股骨颈裂纹和股骨近端前侧骨折在 CFP 股骨柄患者中更为常见。作为一种保留股骨颈的股骨柄，剩余股骨颈的解剖特征（如颈干角、保留长度）可能会影响CFP柄患者术中假体周围股骨骨折的发生率和特征。 (c) 2019 Elsevier Inc. 保留所有权利。
Background: The collum femoris preserving (CFP) stem was a specially designed femoral neck preserving component. The incidence, classification, and risk factors for intraoperative periprosthetic femoral fractures with this special stem remain unclear.Methods: This was a retrospective study. We analyzed the clinical and radiological data of all patients who underwent primary hip arthroplasty with a CFP stem in our hospital between January 2006 and November 2018. Demographic characteristics and radiological features were obtained from the medical records and the Picture Archiving and Communication System, respectively. The incidence, Vancouver classification, and risk factors for intraoperative periprosthetic femoral fractures were identified.Results: A total of 1633 hips were included. The incidence rate of periprosthetic femoral fractures in patients undergoing total hip arthroplasty with a CFP stem was 3.2%. According to the Vancouver classification, there were 24 patients (45.3%) with Vancouver type A fractures, 27 patients (50.9%) with Vancouver type B fractures, and 2 patients (3.8%) with Vancouver type C fractures. Five independent risk (protective) factors were found, including surgical history (odds ratio [OR] = 3.275, 95% confidence interval [CI] = 1.192-8.997), neck-shaft angle (OR = 1.104, 95% CI = 1.058-1.152), neck length preserved (OR = 0.913, 95% CI = 0.850-0.980), canal flare index (OR = 0.636, 95% CI = 0.413-0.980), and bone mineral density (OR = 0.083, 95% CI = 0.016-0.417).Conclusion: The detailed characteristics of intraoperative periprosthetic femoral fractures in patients who received a CFP stem were identified in this study. Cracks of the femoral neck and fractures on the front side of the proximal femur were more common in patients with CFP stems. As a kind of a femoral neck preserving stem, the anatomical features (eg, neck-shaft angle, preserving length) of the remaining femoral neck might influence the incidence and characteristics of intraoperative periprosthetic femoral fractures in patients with CFP stems. (c) 2019 Elsevier Inc. All rights reserved.