Chatziagorou Georgios, Lindahl Hans, Garellick Göran, Kärrholm Johan
1 The Swedish Hip Arthroplasty Register, Gothenburg, Sweden.
2 Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
Hip Int. 2019 May;29(3):282-288. doi: 10.1177/1120700018779558. Epub 2018 Jul 16.
Periprosthetic femoral fractures (PPFF), treated surgically, have been recorded in the Swedish Hip Arthroplasty Register (SHAR) since 1979. It is postulated that fractures treated with other methods other than stem revision have a lower registration rate, which may lead to incomplete registry data and thus, inaccurate information. We collected all PPFFs surgically treated in Sweden between 2001 and 2011 with the purpose of studying the annual incidence, demographics and distribution of fracture types with regard to type of fixation.
Data was linked between the SHAR and the National Patient Register (NPR) in order to detect even those PPFFs not reported to the SHAR. Fractures were classified according to the Vancouver classification system, based on information collected from the medical charts. This procedure was validated with observer variation analysis compared to fracture classification based on radiographs. In total 1751 first-time PPFFs around primary conventional stems were included.
The incidence of PPFF increased from about 1.0 per 1000 primary THRs to 1.4. Vancouver type C fractures (37% of all fractures) were more common than previously reported, and more common in cemented than in uncemented stems. The 3 most common stem designs involved were Exeter polished, Lubinus SPII, and Charnley (66.3% of all stems), partly reflecting their occurrence in the Swedish THR population.
The incidence of PPFFs has increased in Sweden during the period 2001 to 2011. The improved reporting of type C fractures, after data-linking, revealed an almost 4 times higher incidence compared to previous register studies in Sweden.
自1979年起，瑞典髋关节置换登记处（SHAR）就记录了接受手术治疗的人工关节周围股骨骨折（PPFF）。据推测，采用柄部翻修以外的其他方法治疗的骨折登记率较低，这可能导致登记数据不完整，从而信息不准确。我们收集了2001年至2011年间在瑞典接受手术治疗的所有PPFF，目的是研究年度发病率、人口统计学以及骨折类型在固定方式方面的分布情况。
将SHAR与国家患者登记处（NPR）的数据进行关联，以便发现即使未向SHAR报告的PPFF。根据从病历中收集的信息，按照温哥华分类系统对骨折进行分类。与基于X线片的骨折分类相比，通过观察者变异分析对该程序进行了验证。总共纳入了1751例围绕初次传统柄部的首次PPFF。
PPFF的发病率从每1000例初次全髋关节置换术约1.0例增至1.4例。温哥华C型骨折（占所有骨折的37%）比先前报告的更为常见，在骨水泥固定柄部中比在非骨水泥固定柄部中更常见。所涉及的3种最常见的柄部设计是埃克塞特抛光柄、卢比努斯SPII柄和查恩利柄（占所有柄部的66.3%），部分反映了它们在瑞典全髋关节置换人群中的出现情况。
2001年至2011年期间，瑞典PPFF的发病率有所上升。数据关联后，C型骨折报告的改善显示其发病率比瑞典先前登记研究高出近4倍。
