From the Department of Orthopedics, Cleveland Clinic Foundation, Cleveland, OH (Siddiqi, Piuzzi), the Department of Orthopedics Atrium, OrthoCarolina Hip and Knee Center, Musculoskeletal Institute, Charlotte, NC (Springer), and the Department of Orthopedics, Brigham and Women's Hospital, Boston, MA (Chen).
J Am Acad Orthop Surg. 2021 May 15;29(10):e497-e512. doi: 10.5435/JAAOS-D-20-00818.
Intraoperative periprosthetic fractures are challenging complications that may affect implant stability and survivorship. Periprosthetic acetabular fractures are uncommon and infrequently are the focus of studies. Acetabular fractures are occasionally recognized after patients report unremitting groin pain weeks postoperatively. The widespread use of cementless acetabular cups might lead to higher number of fractures than is clinically detectable. Conversely, the incidence of intraoperative periprosthetic femoral fractures are more common and encompass a broad spectrum, ranging from a small cortical perforation to displaced fractures with an unstable prosthesis. Appropriate recognition, including mindfulness of preoperative patient and surgical risk factors, is critical to the successful management of acetabular and femoral complications. This comprehensive review article focuses on the incidence, patient and surgical risk factors, diagnosis, management, and clinical outcomes associated with intraoperative acetabular and femur fractures in primary total hip arthroplasty.
术中假体周围骨折是一种具有挑战性的并发症，可能会影响假体的稳定性和存活率。假体周围髋臼骨折并不常见，也很少成为研究的焦点。患者在术后数周报告持续腹股沟疼痛后，偶尔会发现髋臼骨折。非骨水泥髋臼杯的广泛使用可能会导致比临床检测到更多的骨折。相反，术中假体周围股骨骨折的发生率更高，范围广泛，从小的皮质穿孔到假体不稳定的移位骨折。适当的识别，包括术前患者和手术风险因素的意识，对髋臼和股骨并发症的成功管理至关重要。这篇综述文章重点介绍了初次全髋关节置换术中髋臼和股骨骨折的发生率、患者和手术风险因素、诊断、治疗以及与这些骨折相关的临床结果。
