Ponzio Danielle Y, Shahi Alisina, Park Andrew G, Purtill James J
Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
J Arthroplasty. 2015 Aug;30(8):1418-22. doi: 10.1016/j.arth.2015.02.043. Epub 2015 Mar 7.
Intraoperative proximal femoral fracture is a complication of primary cementless total hip arthroplasty (THA) at rates of 2.95-27.8%. A retrospective review of 2423 consecutive primary cementless THA cases identified 102 hips (96 patients) with fracture. Multivariate analysis compared fracture incidences between implants, Accolade (Stryker Orthopaedics) and Tri-Lock (DePuy Orthopaedics, Inc.), and evaluated potential risk factors using a randomized control group of 1150 cases without fracture. The fracture incidence was 4.4% (102/2423), 3.7% (36/1019) using Accolade and 4.9% using Tri-Lock (66/1404) (P=0.18). Female gender (OR=1.96; 95% CI 1.19-3.23; P=0.008) and smaller stem size (OR=1.64; 95% CI 1.04-2.63; P=0.03) predicted increased odds of fracture. No revisions of the femoral component were required in the fracture cohort.
术中股骨近端骨折是初次非骨水泥型全髋关节置换术（THA）的一种并发症，发生率为2.95%-27.8%。对2423例连续的初次非骨水泥型THA病例进行回顾性分析，确定了102例（96例患者）发生骨折的髋关节。多变量分析比较了Accolade（史赛克骨科）和Tri-Lock（捷迈骨科公司）两种假体之间的骨折发生率，并使用1150例无骨折的随机对照组评估潜在风险因素。骨折发生率为4.4%（102/2423），使用Accolade的骨折发生率为3.7%（36/1019），使用Tri-Lock的骨折发生率为4.9%（66/1404）（P=0.18）。女性（比值比=1.96；95%可信区间1.19-3.23；P=0.008）和较小的假体柄尺寸（比值比=1.64；95%可信区间1.04-2.63；P=0.03）预示骨折几率增加。骨折队列中无需对股骨部件进行翻修。
