An Analysis of Reported Cases of Fracture of the Universal Exeter Femoral Stem Prosthesis
An Analysis of Reported Cases of Fracture of the Universal Exeter Femoral Stem Prosthesis
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DOI：
10.1016/j.arth.2016.09.032
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发表时间：
2017-04-01
影响因子：
3.5
通讯作者：
Gie, Graham A.
中科院分区：
文献类型：
--
作者：
Bolland, Ben J. R. F.;Wilson, Matthew J.;Gie, Graham A.
背景：1991年至2008年期间，报告了约80例骨折（股骨颈或股骨柄）。本研究的目的是确定种植体断裂的诱发因素。方法：收集临床、手术、影像学和检索资料。与骨折相关的风险因素分为患者相关（体重和活动水平）、手术相关（内侧支撑差、部件尺寸和放置）和解剖/植入物相关（股骨头尺寸/偏心距）。股骨颈和股骨柄骨折的平均患者年龄相似（分别为69岁和67岁）。此外，77%的股骨颈骨折和52%的股骨柄骨折发生在男性中。股骨颈平均体重为107 kg，股骨柄骨折平均体重为96.5 kg，其中68%的股骨颈骨折和38%的股骨柄骨折为肥胖或病态肥胖。股骨颈和股骨柄骨折的平均断裂时间分别为78个月（范围：36- 144个月）和76个月（范围：2-155个月）。44#2和44#3是与股骨颈骨折相关的最常见尺寸。股骨柄断裂在较小尺寸（35.5 - 44#1）中更常见（84%）。69%的股骨颈骨折和14%的股骨柄骨折使用了加长型股骨头。结论：股骨颈骨折最常见的与患者相关（体重增加和活动）和植入物相关（使用加长型股骨头）因素相关。股骨柄断裂最常与可纠正的外科相关原因相关，主要继发于股骨柄尺寸过小或内侧支撑不足（84%）。(C)2016 Elsevier Inc. All rights reserved.
Background: Between 1991 and 2008, approximately 80 cases of fracture (neck or stem) have been reported. This study aimed at determining factors predisposing to implant fracture.Methods: Clinical, surgical, radiological, and retrieval data were collated. Risk factors associated with fracture were categorized to patient related (weight and activity levels), surgical related (poor medial support, component size, and placement), and anatomic/implant related (head size/offset).Results: Datawas available on 60 patients (32 stem and 28 neck fractures). Meanpatient age at fracture was similar for both neck and stem fractures (69 years, 67 years, respectively). Also, 77% neck and 52% stem fractures occurred in men. Mean weight was 107 kg in neck and 96.5 kg in stem fractures with 68% neck and 38% stem fractures either obese or morbidly obese. Mean time to fracture was 78 months (range, 36-144months) for neck and 76 months (range, 2-155 months) for stem fractures. 44#2 and 44#3 were the most common sizes associated with neck fractures. Stem fractures occurred more commonly (84%) in the smaller sizes (35.5 to 44#1). Elongated femoral heads were used in 69% neck and 14% stem fractures.Conclusion: Neck fractures were most commonly associated with patient-related (increased weight and activity) and implant-related (use of an elongated femoral head) factors. Stem fractures were most commonly associated with correctable surgical-related causes, predominantly secondary to stem undersizing or inadequate medial support (84%). (C) 2016 Elsevier Inc. All rights reserved.