Department of Orthopaedic Surgery, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Chunbo-Ro 271, Uijeongbu, Gyeonggi-Do, South Korea.
Department of Orthopaedic Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daeheung-Ro 64, Daejeon, South Korea.
Int Orthop. 2024 Mar;48(3):667-674. doi: 10.1007/s00264-023-05988-3. Epub 2023 Sep 19.
Unlike periprosthetic femoral fractures, periprosthetic acetabular fractures during total hip arthroplasty (THA) have not been evaluated in detail. We prospectively evaluated the incidence, patterns, risk factors, and clinical outcomes of intraoperative periprosthetic acetabular fractures using pre- and postoperative computer tomography (CT).
In this prospective single-centre study, we evaluated 234 consecutive patients (250 hips) who underwent THA and three-dimensional CT before and after the surgery. We assessed the incidence, pattern of fractures, outcomes for each fracture pattern, reoperation and revision rates, Harris hip score, and visual analog scale (VAS) for pain. Multivariate regression models were used to identify risk factors for periprosthetic acetabular fractures.
In total, 43 periprosthetic acetabular fractures (17.2%) were identified via CT. Fractures occurred most frequently at the superolateral wall. Early cup migration occurred in three hips. None of the patients underwent revision surgery for acetabular loosening. Regression modeling showed that rheumatoid arthritis was a significant predictor of periprosthetic acetabular fractures.
Periprosthetic acetabular fractures are not infrequent during cementless THA and are more common in patients with rheumatoid arthritis.
与全髋关节置换术（THA）中的股骨假体周围骨折不同，假体周围髋臼骨折尚未得到详细评估。我们前瞻性地使用术前和术后计算机断层扫描（CT）评估了使用骨水泥的 THA 中术中假体周围髋臼骨折的发生率、类型、危险因素和临床结果。
在这项前瞻性单中心研究中，我们评估了 234 例连续患者（250 髋），这些患者在手术前后均接受了 THA 和三维 CT 检查。我们评估了骨折的发生率、骨折类型、每种骨折类型的结果、再次手术和翻修率、Harris 髋关节评分和疼痛视觉模拟评分（VAS）。使用多元回归模型来确定假体周围髋臼骨折的危险因素。
总共通过 CT 识别出 43 例假体周围髋臼骨折（17.2%）。骨折最常发生在外侧壁。有 3 髋发生早期杯迁移。没有患者因髋臼松动而行翻修手术。回归模型显示类风湿关节炎是假体周围髋臼骨折的显著预测因子。
在非骨水泥 THA 中，假体周围髋臼骨折并不少见，在类风湿关节炎患者中更为常见。
