University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Pittsburgh, Pennsylvania.
University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Pittsburgh, Pennsylvania.
J Arthroplasty. 2014 Feb;29(2):422-7. doi: 10.1016/j.arth.2013.06.009. Epub 2013 Jul 12.
To examine the mortality and implant survivorship of proximal femoral replacement (PFR), revision total hip arthroplasty (REV) and open reduction internal fixation (ORIF) in the treatment of acute periprosthetic fractures of the proximal femur, we retrospectively reviewed 97 consecutive acute periprosthetic proximal femoral fractures from 2000 to 2010. Three groups were defined: PFR (n=21), REV (n=19), and ORIF (n=57). Outcome measures were all-cause mortality, implant failure, and reoperation. Competing Risks survival analysis of overall mortality during the mean 35-month follow-up showed no statistical difference between the three groups (P=0.65; 12 and 60 month mortality for PFR: 37%, 45%; REV: 16%, 46%; ORIF: 14%, 100%). Implant survival was worse for the PFR group (P=0.03, 12 and 60-month implant failure rate for PFR: 5%, 39%; REV: 7%, 7%; ORIF 2%, 2%). We conclude that PFR as compared with REV or ORIF may have worse medium-term implant survival, primarily due to instability and dislocation.
为了研究近端股骨置换术（PFR）、翻修全髋关节置换术（REV）和切开复位内固定术（ORIF）治疗股骨近端假体周围骨折的死亡率和植入物存活率，我们回顾性分析了 2000 年至 2010 年连续 97 例股骨近端假体周围急性骨折患者。将患者分为三组：PFR（n=21）、REV（n=19）和 ORIF（n=57）。评估指标为全因死亡率、植入物失败和再次手术。在平均 35 个月的随访中，对所有原因死亡率的竞争风险生存分析显示三组之间无统计学差异（P=0.65；PFR 的 12 个月和 60 个月死亡率：37%、45%；REV：16%、46%；ORIF：14%、100%）。PFR 组的植入物存活率更差（P=0.03，PFR 的 12 个月和 60 个月植入物失败率：5%、39%；REV：7%、7%；ORIF：2%、2%）。我们的结论是，与 REV 或 ORIF 相比，PFR 可能具有更差的中期植入物存活率，主要是由于不稳定和脱位。
