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转子间截骨术在初次和翻修全髋关节置换术中:非愈合的风险因素。

Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union.

机构信息

Department of Orthopaedics, University of Zurich, Balgrist Hospital, Forchstrasse 340, CH 8008 Zurich, Switzerland.

出版信息

Arch Orthop Trauma Surg. 2012 May;132(5):711-7. doi: 10.1007/s00402-011-1457-4. Epub 2012 Jan 7.

DOI:10.1007/s00402-011-1457-4
PMID:22228280
Abstract

BACKGROUND

Trochanteric osteotomies (TO) facilitate exposure and "true hip reconstruction" in complex primary and revision total hip arthroplasty (THA). However, non-union represents a clinically relevant complication. The purpose of the present study was to identify risk factors for trochanteric non-union.

METHODS

All cases of THA approached by TO during the past 10 years were analyzed with respect to potential risk factors for non-union.

RESULTS

In 298 cases complete data were available for analysis. Trochanteric union occurred in 80.5%, fibrous union in 5.4% and non-union 14.1%. Risk factor analysis revealed a four times higher risk for non-union in anterior trochanteric slide osteotomies compared to extended trochanteric osteotomies and a three times higher risk in cemented versus non-cemented stems. Multiple logistic regression analysis revealed patient's age and use of cement to be independent risk factors for non-union.

CONCLUSIONS

Femoral cementation and increasing age negatively influence the union of trochanteric osteotomies.

摘要

背景

转子间截骨术(TO)有助于在复杂的初次和翻修全髋关节置换术(THA)中暴露并进行“真正的髋关节重建”。然而,不愈合是一个具有临床相关性的并发症。本研究的目的是确定转子间不愈合的危险因素。

方法

分析了过去 10 年中通过 TO 进行 THA 的所有病例,以评估其不愈合的潜在危险因素。

结果

在 298 例病例中,有完整数据可供分析。转子间愈合 80.5%,纤维性愈合 5.4%,不愈合 14.1%。危险因素分析显示,与延长转子间截骨术相比,前转子间滑动截骨术发生不愈合的风险高 4 倍,与非骨水泥固定相比,骨水泥固定的风险高 3 倍。多因素逻辑回归分析显示,患者年龄和使用骨水泥是不愈合的独立危险因素。

结论

股骨骨水泥固定和年龄增长会对转子间截骨术的愈合产生负面影响。

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