Heterotopic Ossification Following Arthroplasty for Femoral Neck Fracture.
Heterotopic Ossification Following Arthroplasty for Femoral Neck Fracture.
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DOI：
10.2106/jbjs.20.01586
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发表时间：
2021-07-21
期刊：
影响因子：
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通讯作者：
the HEALTH Investigators
中科院分区：
文献类型：
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作者：
Comeau-Gauthier M;Zura RD;Bzovsky S;Schemitsch EH;Axelrod D;Avram V;Manjoo A;Poolman RW;Frihagen F;Heels-Ansdell D;Bhandari M;Sprague S;the HEALTH Investigators
异位骨化（HO）是髋关节手术后常见的并发症。使用来自全髋关节置换术与半髋关节置换术（HEALTH）试验的数据，我们的目的是(1)确定≥50岁的股骨颈骨折患者全髋关节置换术（THA）后HO的患病率，(2)确定HO是否与骨折后24个月内翻修手术风险增加有关，(3)确定HO对功能结局的影响。我们以翻修手术为因变量，HO为自变量，进行多变量Cox回归分析。我们比较了西安大略大学和麦克马斯特大学24个月时骨关节炎指数（WOMAC）评分。在1441名参与者中，287名（19.9%）在24个月内发展为HO。HO与随后的翻修手术无关。与I级或II级相比，iii级HO与WOMAC总评分的恶化有统计学意义且具有临床相关性，主要与评分的功能成分有关。iii级HO对髋部骨折THA术后功能结局和生活质量的影响具有重要的临床意义，对特定高危患者进行HO预防可能是合适的。预后三级。有关证据水平的完整描述，请参见作者说明。
Heterotopic ossification (HO) is a frequent complication following hip surgery. Using data from the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial, we aimed to (1) determine the prevalence of HO following total hip arthroplasty (THA) for femoral neck fracture in patients ≥50 years of age, (2) identify whether HO is associated with an increased risk of revision surgery within 24 months after the fracture, and (3) determine the impact of HO on functional outcomes. We performed a multivariable Cox regression analysis using revision surgery as the dependent variable and HO as the independent variable. We compared Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between participants with and those without HO at 24 months. Of 1,441 participants in the study, 287 (19.9%) developed HO within 24 months. HO was not associated with subsequent revision surgery. Grade-III HO was associated with statistically significant and clinically relevant deterioration in the total WOMAC score, which was mainly related to the function component of the score, compared with grade I or II. The impact of grade-III HO on the functional outcomes and quality of life after THA for hip fracture is clinically important, and HO prophylaxis for selected high-risk patients may be appropriate. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.