Burke John F, Quinlan Nicole D, Werner Brian C, Barnes C Lowry, Browne James A
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
J Arthroplasty. 2023 Jan;38(1):24-29. doi: 10.1016/j.arth.2022.08.016. Epub 2022 Aug 13.
Osteopetrosis is a rare, inherited disorder in which bone remodels to become pathologically dense. There has been a paucity of data evaluating medical and surgical complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in this patient population. The objective of this study was to evaluate osteopetrosis as a potential risk factor for medical and surgical complications following THA and TKA.
Patients who had a diagnosis of osteopetrosis and underwent THA or TKA from 2010 to 2020 were identified in a national database. A total of 534 THA and 972 TKA patients who had osteopetrosis were identified and compared with matched cohorts of 2,670 and 4,860 patients, respectively. The rates of postoperative medical and surgical complications, hospital readmissions, and emergency room visits were calculated. In addition, reimbursements and lengths of stay were determined. Osteopetrosis patients were then compared to a 5:1 matched cohort without osteopetrosis using logistic regression analyses to control for additional confounding factors.
The osteopetrosis THA group had a substantially higher incidence of intraoperative periprosthetic fracture compared to the matched cohort (1.12% versus 0.19%, Odds Ratio 5.88, P = .005). Patients who had a history of osteopetrosis were not found to be at a significantly increased risk for other investigated medical or surgical complications compared to matched controls following THA or TKA.
Patients who had a history of osteopetrosis undergoing elective primary THA are associated with a significantly increased risk for intraoperative periprosthetic fracture. Patients with a history of osteopetrosis undergoing elective primary TKA were not found to be at an increased risk for any of the investigated complications.
骨质石化症是一种罕见的遗传性疾病，其骨骼重塑后会出现病理性致密。在这一患者群体中，评估全髋关节置换术（THA）和全膝关节置换术（TKA）后内科及外科并发症的数据较少。本研究的目的是评估骨质石化症作为THA和TKA后内科及外科并发症的潜在危险因素。
在一个全国性数据库中识别出2010年至2020年期间诊断为骨质石化症并接受THA或TKA的患者。共识别出534例接受THA和972例接受TKA的骨质石化症患者，并分别与2670例和4860例匹配队列进行比较。计算术后内科及外科并发症、医院再入院率和急诊室就诊率。此外，确定费用报销情况和住院时间。然后，使用逻辑回归分析将骨质石化症患者与5:1的无骨质石化症匹配队列进行比较，以控制其他混杂因素。
与匹配队列相比，骨质石化症THA组术中假体周围骨折的发生率显著更高（1.12%对0.19%，优势比5.88，P = .005）。与THA或TKA后的匹配对照组相比，有骨质石化症病史的患者未发现其他所调查的内科或外科并发症风险显著增加。
有骨质石化症病史的患者接受择期初次THA时，术中假体周围骨折风险显著增加。有骨质石化症病史的患者接受择期初次TKA时，未发现任何所调查并发症的风险增加。
