Lipof Jason S, Amitai Ari D, Judd Kyle T, Gorczyca John T
Iowa Orthop J. 2017;37:35-39.
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common orthopaedic procedures performed in the United States annually. As the number of patients undergoing these procedures increases so too does the incidence of periprosthetic femur fractures. A number of these periprosthetic fractures occur between two ipsilateral implants, so-called interprosthetic fractures. Recent biomechanical data has challenged the importance of these interprosthetic distances, relating that cortical width and osteoporotic bone are more closely correlated with fracture than interprosthetic distance. The purpose of the current study is to further define the presence of osteoporosis, cortical width (CW) and medullary diameter (MD) as potential predictive factors for interprosthetic femur fractures.
Current Procedural Terminology (CPT) codes were used to identify a cohort of patients undergoing operative treatment for periprosthetic femur fractures. A review of the medical records identified 23 patients (5 male / 18 female) with a femur fracture between two intramedullary implants. CPT codes were also used to identify a second cohort of 25 patients (8 male / 17 female) having undergone ipsilateral THA and TKA. The intact femoral isthmus was identified radiographically and the MD and CW (mm) were measured. A ratio of MD to CW was also determined. Chart review was undertaken and any diagnosis of osteoporosis was recorded. An independent sample T-test was performed comparing the mean MD, CW, and the ratio of MD:CW for these groups. Significance was set at p.
全髋关节置换术（THA）和全膝关节置换术（TKA）是美国每年最常见的骨科手术。随着接受这些手术的患者数量增加，假体周围股骨骨折的发生率也在上升。许多这些假体周围骨折发生在两个同侧植入物之间，即所谓的假体间骨折。最近的生物力学数据对这些假体间距离的重要性提出了质疑，认为皮质宽度和骨质疏松性骨与骨折的相关性比假体间距离更密切。本研究的目的是进一步确定骨质疏松、皮质宽度（CW）和髓腔直径（MD）作为假体间股骨骨折潜在预测因素的存在情况。
使用当前手术操作术语（CPT）代码识别一组接受假体周围股骨骨折手术治疗的患者。对病历的审查确定了23例（5例男性/18例女性）在两个髓内植入物之间发生股骨骨折的患者。CPT代码还用于识别另一组25例（8例男性/17例女性）接受同侧THA和TKA的患者。通过X线片确定完整的股骨干峡部，并测量MD和CW（毫米）。还确定了MD与CW的比值。进行病历审查并记录任何骨质疏松的诊断。对这些组的平均MD、CW以及MD:CW比值进行独立样本T检验。显著性设定为p。
