Davidson Darin, Pike Jeffrey, Garbuz Donald, Duncan Clive P, Masri Bassam A
Division of Lower Limb Reconstruction and Oncology, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC V5Z 4E3, Canada.
J Bone Joint Surg Am. 2008 Sep;90(9):2000-12. doi: 10.2106/JBJS.H.00331.
Intraoperative periprosthetic fractures are becoming more common given the increased prevalence of revision total hip arthroplasty and increased use of cementless fixation. Risk factors for intraoperative periprosthetic fractures include the use of minimally invasive techniques; the use of press-fit cementless stems; revision operations, especially when a long cementless stem is used or when a short stem with impaction allografting is used; female sex; metabolic bone disease; bone diseases leading to altered morphology such as Paget disease; and technical errors at the time of the operation. Appropriate treatment of intraoperative periprosthetic fractures does not compromise the long-term results of total hip arthroplasty unless the bone damage precludes stable fixation of the implant.
鉴于翻修全髋关节置换术的患病率增加以及非骨水泥固定的使用增多，术中假体周围骨折正变得越来越常见。术中假体周围骨折的危险因素包括使用微创技术；使用压配式非骨水泥柄；翻修手术，尤其是当使用长的非骨水泥柄或使用带有嵌压异体骨移植的短柄时；女性；代谢性骨病；导致形态改变的骨病，如佩吉特病；以及手术时的技术失误。术中假体周围骨折的适当治疗不会影响全髋关节置换术的长期效果，除非骨损伤妨碍了植入物的稳定固定。
