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？
Are gender, comorbidity, and obesity risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty?
机构信息
Medicine Service and Center for Surgical Medical Acute Care Research and Transitions (CSMART), Birmingham VA Medical Center, Birmingham, Alabama 35294, USA.
出版信息
J Arthroplasty. 2013 Jan;28(1):126-31.e1-2. doi: 10.1016/j.arth.2012.03.010. Epub 2012 Apr 30.
Abstract
We studied the frequency and patient risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty (THA). With a mean follow-up of 6.3 years, 305 postoperative periprosthetic fractures occurred in 14,065 primary THAs. In multivariable-adjusted Cox regression analyses, female gender (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.17-1.88), Deyo-Charlson comorbidity score of 2 (HR, 1.74 for score of 2; 95% CI, 1.25-2.43) or 3 or higher (HR, 1.71; 95% CI, 1.26-2.32), and American Society of Anesthesiologist class of 2 (HR, 1.84; 95% CI, 0.90-3.76) or 3 (HR, 2.45; 95% CI, 1.18-5.1) or 4 or higher (HR, 2.68; 95% CI, 0.70-10.28) were significantly associated with higher risk/hazard, and cemented implant, with lower hazard (HR, 0.68; 95% CI, 0.54-0.87) of postoperative periprosthetic fractures. Interventions targeted at optimizing comorbidity management may decrease postoperative fractures after THA.
摘要
我们研究了初次全髋关节置换术后（THA）假体周围骨折的频率和患者危险因素。平均随访 6.3 年，在 14065 例初次 THA 中发生了 305 例术后假体周围骨折。在多变量调整的 Cox 回归分析中，女性性别（风险比 [HR]，1.48；95%置信区间 [CI]，1.17-1.88）、Deyo-Charlson 合并症评分 2 分（HR，1.74；95%CI，1.25-2.43）或 3 分或更高（HR，1.71；95%CI，1.26-2.32）和美国麻醉医师协会（ASA）分级 2 分（HR，1.84；95%CI，0.90-3.76）或 3 分（HR，2.45；95%CI，1.18-5.1）或 4 分或更高（HR，2.68；95%CI，0.70-10.28）与更高的风险/危险显著相关，而骨水泥固定假体与较低的假体周围骨折危险相关（HR，0.68；95%CI，0.54-0.87）。针对优化合并症管理的干预措施可能会降低 THA 后的术后骨折风险。
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