初次全髋关节置换术和翻修术围手术期股骨假体周围骨折的病死率。
Mortality After Periprosthetic Femur Fractures During and After Primary and Revision Total Hip Arthroplasty.
机构信息
From the Department of Orthopedic Surgery (Dr. Maradit Kremers, Dr. Abdel, Dr. Lewallen, and Dr. Berry), and the Department of Health Sciences Research (Dr. Maradit Kremers, Ms. Ransom, and Mr. Larson), Mayo Clinic, Rochester, MN.
出版信息
J Am Acad Orthop Surg. 2019 May 15;27(10):375-380. doi: 10.5435/JAAOS-D-17-00902.
INTRODUCTION
We determined mortality rates after intraoperative and postoperative periprosthetic femur fractures in primary and revision total hip arthroplasty (THA).
METHODS
The study population comprised 522 intraoperative and 480 postoperative femur fractures in 26,250 primary THA patients and 590 intraoperative and 224 postoperative femur fractures in 4,532 revision THA patients. The risk of death was examined using Cox regression models.
RESULTS
In primary THA, intraoperative periprosthetic femur fractures were not associated with excess risk of death (hazard ratio, 1.03; 95% confidence interval, 0.86 to 1.22). The risk of death was slightly elevated among primary THA patients with postoperative femur fractures (hazard ratio, 1.19; 95% confidence interval, 1.08 to 1.43), but the excess risk was only confined to patients with comorbid orthopaedic conditions. In revision THA, neither intraoperative nor postoperative periprosthetic femur fractures were associated with excess risk of death.
CONCLUSION
Periprosthetic femur fractures are not associated with excess mortality among primary osteoarthritis patients.
LEVEL OF EVIDENCE
Level III.
引言
我们确定了初次全髋关节置换术（THA）和翻修 THA 术中及术后假体周围股骨骨折的死亡率。
方法
研究人群包括 26250 例初次 THA 患者中的 522 例术中和 480 例术后股骨骨折，以及 4532 例翻修 THA 患者中的 590 例术中和 224 例术后股骨骨折。使用 Cox 回归模型检查死亡风险。
结果
在初次 THA 中，假体周围股骨术中骨折与死亡风险增加无关（风险比，1.03；95%置信区间，0.86 至 1.22）。初次 THA 患者术后股骨骨折的死亡风险略有升高（风险比，1.19；95%置信区间，1.08 至 1.43），但这种超额风险仅局限于合并骨科疾病的患者。在翻修 THA 中，术中或术后假体周围股骨骨折均与死亡风险增加无关。
结论
假体周围股骨骨折与原发性骨关节炎患者的死亡率增加无关。
证据等级
III 级。
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