全髋关节置换术后股骨假体颈部骨折——一项系统评价
Femoral prosthesis neck fracture following total hip arthroplasty - a systematic review.
作者信息
van Doesburg P G, van Langelaan E J, Apachitei I, Bénard M R, Verdegaal S H M
机构信息
Department of Orthopaedic Surgery, Alrijne Hospital Leiderdorp, Simon Smitweg 1, 2353GA, Leiderdorp, The Netherlands.
Biomechanical Engineering Department Biomaterials & Tissue Biomechanics Section, Delft University of Technology, Delft, The Netherlands.
出版信息
Arthroplasty. 2020 Oct 16;2(1):28. doi: 10.1186/s42836-020-00047-3.
PURPOSE
Head-neck modularity was introduced into total hip arthroplasty to provide more intraoperative surgical options. However, modularity led to new problems, such as trunnionosis and fractures of the femoral prosthesis neck. The purpose of this study was to identify risk factors for hip neck fractures and to provide recommendations to prevent damage and fractures of the neck.
METHODS
A systematic review of the literature was performed according to the PRISMA guidelines.
RESULTS
Thirty-three case studies were included. Methodologically, most included studies were of moderate or good quality. The 80 neck fractures included in the review took place, on average, 7 years after stem placement. Male gender, high body weight, obesity, previous revision surgery, mixing components from different manufacturers, use of long skirted heads, cobalt-chromium (large size) heads were identified as potential risk factors.
CONCLUSION
Hip neck fractures occur on average 7 years after stem placement. The etiology of hip neck fractures is multifactorial. This review revealed several preventable implant- and surgeon-related risk factors.
目的
全髋关节置换术中引入头颈模块化设计以提供更多术中手术选择。然而，模块化导致了新问题，如股骨柄假体的柄部病变和颈部骨折。本研究的目的是确定髋部颈部骨折的危险因素，并提供预防颈部损伤和骨折的建议。
方法
根据PRISMA指南对文献进行系统综述。
结果
纳入33项病例研究。从方法学角度来看，大多数纳入研究质量中等或良好。综述中纳入的80例颈部骨折平均发生在股骨柄植入后7年。男性、高体重、肥胖、既往翻修手术、混用不同制造商的组件、使用长裙边股骨头、钴铬（大尺寸）股骨头被确定为潜在危险因素。
结论
髋部颈部骨折平均发生在股骨柄植入后7年。髋部颈部骨折的病因是多因素的。本综述揭示了一些与植入物和外科医生相关的可预防危险因素。
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