患者因素可预测全髋关节翻修术后的假体周围骨折。
Patient factors predict periprosthetic fractures after revision total hip arthroplasty.
机构信息
Medicine Service and Center for Surgical Medical Acute care Research and Transitions (C-SMART), Birmingham VA Medical Center, Birmingham, AL, USA.
出版信息
J Arthroplasty. 2012 Sep;27(8):1507-12. doi: 10.1016/j.arth.2011.12.010. Epub 2012 Feb 15.
Abstract
We assessed important patient risk factors for postoperative periprosthetic fractures after revision total hip arthroplasty (THA) using prospectively collected Institutional Joint Registry data. We used univariate and multivariable-adjusted Cox regression analyses. There were 330 postoperative periprosthetic fractures after 6281 revision THAs. In multivariable-adjusted analyses, hazard ratio (95% confidence interval) of periprosthetic fracture was higher for women (1.66 [1.32-2.080], P < .001), a higher Deyo-Charlson comorbidity index of 2 (1.46 [1.03-2.07]) and index of 3+ (2.01 [1.48-2.73]; overall, P < .001), and operative diagnosis, especially previous nonunion (5.76 [2.55-13.02]; overall, P < .001). Hazard ratio was lower in patients 61 to 70 years old (0.64 [0.49-0.84]) and 71 to 80 years old (0.57 [0.43-0.76]) compared with those younger than 60 years (overall, P < .0001). Our study identified important modifiable and unmodifiable risk factors for fractures after revision THA.
摘要
我们使用前瞻性收集的机构关节登记数据评估了全髋关节翻修术后假体周围骨折的重要患者风险因素。我们使用了单变量和多变量调整的 Cox 回归分析。在 6281 例全髋关节翻修术后，有 330 例出现术后假体周围骨折。在多变量调整分析中，女性发生假体周围骨折的风险比（95%置信区间）更高（1.66 [1.32-2.080]，P<.001），Deyo-Charlson 合并症指数为 2（1.46 [1.03-2.07]）和指数为 3+（2.01 [1.48-2.73]；总体，P<.001）更高，以及手术诊断，特别是先前的骨不连（5.76 [2.55-13.02]；总体，P<.001）。与 60 岁以下的患者相比，61-70 岁（0.64 [0.49-0.84]）和 71-80 岁（0.57 [0.43-0.76]）的患者风险比降低（总体，P<.0001）。我们的研究确定了全髋关节翻修术后骨折的重要可改变和不可改变的风险因素。
相似文献
1
Patient factors predict periprosthetic fractures after revision total hip arthroplasty.患者因素可预测全髋关节翻修术后的假体周围骨折。
J Arthroplasty. 2012 Sep;27(8):1507-12. doi: 10.1016/j.arth.2011.12.010. Epub 2012 Feb 15.
2
Peptic ulcer disease and heart disease are associated with periprosthetic fractures after total hip replacement.消化性溃疡病和心脏病与全髋关节置换术后假体周围骨折有关。
Acta Orthop. 2012 Aug;83(4):353-9. doi: 10.3109/17453674.2012.717844. Epub 2012 Aug 20.
3
Prevalence and risk factors for intra-operative periprosthetic fractures in one thousand eight hundred and seventy two patients undergoing total hip arthroplasty: a cross-sectional study.1872例接受全髋关节置换术患者术中假体周围骨折的患病率及危险因素：一项横断面研究
Int Orthop. 2015 Oct;39(10):1939-43. doi: 10.1007/s00264-015-2961-x. Epub 2015 Aug 23.
4
Predictors of periprosthetic fracture after total knee replacement: an analysis of 21,723 cases.全膝关节置换术后假体周围骨折的预测因素：21723 例分析。
Acta Orthop. 2013 Apr;84(2):170-7. doi: 10.3109/17453674.2013.788436. Epub 2013 Mar 26.
5
Seasonality of Periprosthetic Femur Fractures in 12,700 Primary and Revision Total Hip Arthroplasties.12700例初次及翻修全髋关节置换术中股骨假体周围骨折的季节性
J Arthroplasty. 2017 Jun;32(6):2000-2004. doi: 10.1016/j.arth.2017.02.049. Epub 2017 Feb 28.
6
Periprosthetic Fractures: A Rising Tide of Hip Arthroplasty Failure Noted in the American Joint Replacement Registry and the Preventative Role of Cemented Stems.人工关节周围骨折：美国关节置换登记处注意到髋关节置换失败的上升趋势，以及骨水泥固定柄的预防作用。
J Arthroplasty. 2024 Sep;39(9S2):S454-S458. doi: 10.1016/j.arth.2024.06.038. Epub 2024 Jul 1.
7
Are gender, comorbidity, and obesity risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty?性别、合并症和肥胖是初次全髋关节置换术后假体周围骨折的术后危险因素吗？
J Arthroplasty. 2013 Jan;28(1):126-31.e1-2. doi: 10.1016/j.arth.2012.03.010. Epub 2012 Apr 30.
8
[Intra-operative periprosthetic fractures during THA in the period 1995-2009].[1995年至2009年期间全髋关节置换术中的术中假体周围骨折]
Acta Chir Orthop Traumatol Cech. 2013;80(5):341-5.
9
Increased risk of periprosthetic femur fractures associated with a unique cementless stem design.与一种独特的非骨水泥型股骨柄设计相关的假体周围股骨骨折风险增加。
Clin Orthop Relat Res. 2015 Jun;473(6):2045-53. doi: 10.1007/s11999-014-4077-9. Epub 2014 Dec 12.
10
Epidemiology of periprosthetic femoral fractures in 5417 revision total hip arthroplasties: a 40-year experience.5417例翻修全髋关节置换术中假体周围股骨骨折的流行病学：40年经验
Bone Joint J. 2016 Apr;98-B(4):468-74. doi: 10.1302/0301-620X.98B4.37203.
引用本文的文献
1
Multicenter Study of Comorbidities in Patients with Periprosthetic Fractures After Total Hip Arthroplasty and Their Association with Immediate Postoperative Complications.全髋关节置换术后假体周围骨折患者合并症的多中心研究及其与术后即刻并发症的关联
Clin Pract. 2025 Jun 12;15(6):110. doi: 10.3390/clinpract15060110.
2
Risk factors for periprosthetic femoral fractures following hip arthroplasty: a systematic review and meta-analysis.髋关节置换术后假体周围股骨骨折的危险因素：一项系统评价和荟萃分析。
Ann Med. 2025 Dec;57(1):2494679. doi: 10.1080/07853890.2025.2494679. Epub 2025 Apr 23.
3
Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.全球范围内机构和医院为基础（二级至四级）关节置换术登记处的绘制：范围综述。
Eur J Orthop Surg Traumatol. 2024 Feb;34(2):1219-1251. doi: 10.1007/s00590-023-03691-y. Epub 2023 Sep 28.
4
Treatment Algorithm of Periprosthetic Femoral Fracturens.人工关节周围股骨骨折的治疗算法
Geriatr Orthop Surg Rehabil. 2022 May 10;13:21514593221097608. doi: 10.1177/21514593221097608. eCollection 2022.
5
Combined Surgical and Medical Treatment for Vancouver B1 and C Periprosthetic Femoral Fractures: A Proposal of a Therapeutic Algorithm While Retaining the Original Stable Stem.温哥华B1型和C型人工关节周围股骨骨折的手术与药物联合治疗：保留原稳定股骨柄的治疗方案
Geriatr Orthop Surg Rehabil. 2021 Dec 21;12:21514593211067072. doi: 10.1177/21514593211067072. eCollection 2021.
6
Periprosthetic joint infection is the main reason for failure in patients following periprosthetic fracture treated with revision arthroplasty.人工关节周围感染是关节翻修术后治疗人工关节周围骨折患者失败的主要原因。
Arch Orthop Trauma Surg. 2022 Dec;142(12):3565-3574. doi: 10.1007/s00402-021-03948-3. Epub 2021 May 15.
7
Management, outcome, and novel classification system of periprosthetic fractures in patients with transcutaneous osseointegrated prosthetic systems (TOPS)-a retrospective cohort analysis.经皮骨整合假体系统（TOPS）患者的假体周围骨折的管理、结果和新型分类系统：回顾性队列分析。
Arch Orthop Trauma Surg. 2022 Jul;142(7):1499-1509. doi: 10.1007/s00402-021-03826-y. Epub 2021 Mar 6.
8
Factors affecting the incidence of postoperative periprosthetic fractures following primary and revision hip arthroplasty: a systematic review and meta-analysis.影响初次和翻修髋关节置换术后假体周围骨折发生率的因素：系统评价和荟萃分析。
J Orthop Surg Res. 2021 Jan 6;16(1):15. doi: 10.1186/s13018-020-02152-0.
9
Reconstructed the bone stock after femoral bone loss in Vancouver B3 periprosthetic femoral fractures using cortical strut allograft and impacted cancellous allograft.使用皮质骨支撑移植物和打压松质骨移植物重建温哥华 B3 型假体周围股骨骨折股骨骨丢失后的骨量。
Int Orthop. 2018 Dec;42(12):2787-2795. doi: 10.1007/s00264-018-3997-5. Epub 2018 Jun 4.
10
Periprosthetic Femur Fracture Occuring after Contralateral Neglected Femoral Neck Fracture.对侧股骨颈骨折被忽视后发生的人工关节周围股骨骨折
J Orthop Case Rep. 2016 Jan-Mar;6(1):11-3. doi: 10.13107/jocr.2250-0685.364.
本文引用的文献
1
The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement.初次及翻修全髋关节和全膝关节置换术后假体周围骨折的风险。
J Bone Joint Surg Br. 2011 Jan;93(1):96-101. doi: 10.1302/0301-620X.93B1.25087.
2
Demographics, outcomes, and risk factors for adverse events associated with primary and revision total hip arthroplasties in the United States.美国初次和翻修全髋关节置换术相关不良事件的人口统计学、结局及风险因素
Am J Orthop (Belle Mead NJ). 2010 Aug;39(8):E72-7.
3
Higher body mass index is not associated with worse pain outcomes after primary or revision total knee arthroplasty.较高的身体质量指数与初次或翻修全膝关节置换术后的疼痛结果恶化无关。
J Arthroplasty. 2011 Apr;26(3):366-374.e1. doi: 10.1016/j.arth.2010.02.006. Epub 2010 Apr 21.
4
Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty.年龄、性别、肥胖和抑郁与翻修全髋关节置换术后与患者相关的疼痛和功能结局有关。
Clin Rheumatol. 2009 Dec;28(12):1419-30. doi: 10.1007/s10067-009-1267-z. Epub 2009 Aug 31.
5
Functional outcome of femoral peri prosthetic fracture and revision hip arthroplasty: a matched-pair study from the New Zealand Registry.股骨假体周围骨折与髋关节翻修置换术的功能结局：一项来自新西兰注册中心的配对研究。
Acta Orthop. 2008 Aug;79(4):483-8. doi: 10.1080/17453670710015463.
6
Total hip replacement in patients eighty years of age and older.80岁及以上患者的全髋关节置换术。
J Bone Joint Surg Am. 2008 Sep;90(9):1884-90. doi: 10.2106/JBJS.G.00147.
7
The impact of gender, age, and preoperative pain severity on pain after TKA.性别、年龄和术前疼痛严重程度对全膝关节置换术后疼痛的影响。
Clin Orthop Relat Res. 2008 Nov;466(11):2717-23. doi: 10.1007/s11999-008-0399-9. Epub 2008 Aug 5.
8
Mortality after periprosthetic fracture of the femur.股骨假体周围骨折后的死亡率。
J Bone Joint Surg Am. 2007 Dec;89(12):2658-62. doi: 10.2106/JBJS.F.01538.
9
Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.2005年至2030年美国初次和翻修髋关节与膝关节置换术的预测。
J Bone Joint Surg Am. 2007 Apr;89(4):780-5. doi: 10.2106/JBJS.F.00222.
10
Differences in outcomes of obese women and men undergoing primary total hip arthroplasty.接受初次全髋关节置换术的肥胖女性和男性的预后差异。
Arthritis Rheum. 2007 Mar 15;57(2):327-34. doi: 10.1002/art.22542.
Zotero 插件