Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.
Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
BMC Musculoskelet Disord. 2022 Mar 18;23(1):266. doi: 10.1186/s12891-022-05223-x.
The choice of femur stems during the hip arthroplasty procedures for patients with treatment failure of intertrochanteric fractures (ITF) remains controversial. We aimed to compare the surgical complication and reoperation rates between cementless primary and revision stems in the early (≤3 months) and late (> 3 months) fixation failures of ITF.
This was a retrospective, cohort study conducted in a single, tertiary referral hospital of Taipei, Taiwan. We included hip arthroplasty procedures for failed ITF using cementless primary or revision stems. There were 40 and 35 patients who had early and late fixation failure of ITF, respectively. The patient demographics, time to fixation failure, surgical complications and medical complications were recorded for analysis.
We included 75 patients that underwent hip arthroplasty procedure for failed ITF using cementless primary (n = 38) or revision (n = 37) stems. The mean age was 79.3 years and 56% of the patients were female. In the early fixation failure group, the complication rate was similar between the primary and revision stems (44% vs. 29%, p = 0.343). However, there was a trend toward a higher reoperation rate (31% vs. 8%, p = 0.061) of using the primary stem, compared with the revision stem. In the late fixation failure group, the rate of complication and reoperation was similar between the two stem types.
For early fixation failures of ITFs, we caution against the use of cementless primary stems due to a trend towards an increased risk of reoperations compared to the use of cementless revision stems. However, in late fixation failures of ITFs, there is a role for cementless primary stems.
III, retrospective cohort study.
对于治疗失败的转子间骨折（ITF）患者，髋关节置换术中股骨柄的选择仍存在争议。我们旨在比较早期（≤3 个月）和晚期（>3 个月）ITF 固定失败时，非骨水泥初次和翻修柄的手术并发症和再手术率。
这是一项在台湾台北一家单一的三级转诊医院进行的回顾性队列研究。我们纳入了使用非骨水泥初次或翻修柄治疗 ITF 失败的髋关节置换术。分别有 40 例和 35 例患者发生早期和晚期 ITF 固定失败。记录患者人口统计学特征、固定失败时间、手术并发症和医疗并发症进行分析。
我们纳入了 75 例使用非骨水泥初次（n=38）或翻修（n=37）柄治疗 ITF 失败的髋关节置换术患者。平均年龄为 79.3 岁，56%的患者为女性。在早期固定失败组，初次和翻修柄的并发症发生率相似（44%比 29%，p=0.343）。然而，初次柄的再手术率（31%比 8%，p=0.061）有升高的趋势。在晚期固定失败组，两种柄类型的并发症和再手术率相似。
对于 ITF 的早期固定失败，我们不建议使用非骨水泥初次柄，因为与使用非骨水泥翻修柄相比，再次手术的风险增加。然而，在 ITF 的晚期固定失败中，非骨水泥初次柄有一定的作用。
III 级，回顾性队列研究。
