Department of Orthopedic Surgery, Second Hospital of Tangshan, Tangshan, 063000, Hebei, P.R. China.
Institute of Trauma Surgery, Second Hospital of Tangshan, Tangshan, 063000, Hebei, P.R. China.
BMC Musculoskelet Disord. 2023 Oct 13;24(1):811. doi: 10.1186/s12891-023-06945-2.
The predictors of post-traumatic osteoarthritis (PTOA) in patients with transverse acetabular fractures (TAFs) following open reduction internal fixation (ORIF) remain unclear. This study aimed to investigate the risk factors for PTOA in TAFs after ORIF.
Data of TAF patients receiving ORIF were collected from January 2012 and February 2021. Patients suffered PTOA were classified as the osteoarthritis group (OG), while those without PTOA were classified as the non- osteoarthritis group (NG) with a minimum follow-up of 2 years. PTOA was diagnosed according to Tönnis OA classification during the period of follow-up. Univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analyses were used to evaluate demographics, injury-related characteristics, perioperative and post-discharge information.
Three hundred and eleven TAF patients were analyzed in this study, including 261 males and 50 females, with a mean age of 40.4 years (range 18 to 64 years). The incidence of PTOA was 29.6% (92 of 311) during the mean follow-up of 36.8 months (range 24 to 70 months). Several factors of PTOA were found using univariate analysis, including transverse fracture associated with posterior wall acetabular fracture (TPW-AF, p = 0.002), acetabular roof fracture (ARF, p = 0.001), femoral head lesion (FHL, p = 0.016), longer time from injury to surgery (TIS, p＜0.001) and physical work after surgery (PWAS, p＜0.001). Logistic regression analysis showed that TPW-AF (p = 0.007, OR = 2.610, 95%CI: 1.302-5.232), ARF (p = 0.001, OR = 2.887, 95%CI: 1.512-5.512), FHL (p = 0.005, OR = 2.302, 95%CI: 1.283-4.131), TIS (p<0.0001, OR = 1.294, 95%CI: 1.192-1.405) and PWAS (p<0.0001, 3.198, 95%CI: 1.765-5.797) were independent risk factors of PTOA. Furthermore, ROC curve analysis indicated 11.5 days as the cut-off values to predict PTOA.
Our findings identified that TPW-AF, ARF, FHL, TIS and PWAS were independent risk factors for PTOA in patients with TAFs following ORIF. It can help orthopedic surgeons to take early individualized interventions to reduce its incidence.
经切开复位内固定（ORIF）治疗后，髋臼横形骨折（TAFs）患者发生创伤后骨关节炎（PTOA）的预测因素仍不清楚。本研究旨在探讨 ORIF 治疗 TAF 后发生 PTOA 的危险因素。
收集 2012 年 1 月至 2021 年 2 月接受 ORIF 治疗的 TAF 患者的数据。根据随访期间 Tönnis OA 分类，将发生 PTOA 的患者分为骨关节炎组（OG），未发生 PTOA 的患者分为非骨关节炎组（NG），随访时间至少 2 年。单因素分析、逻辑回归分析和受试者工作特征（ROC）曲线分析用于评估人口统计学、损伤相关特征、围手术期和出院后信息。
本研究共分析了 311 例 TAF 患者，其中男性 261 例，女性 50 例，平均年龄 40.4 岁（18-64 岁）。平均随访 36.8 个月（24-70 个月）期间，PTOA 的发生率为 29.6%（92/311）。单因素分析发现 PTOA 的几个相关因素，包括髋臼横形骨折合并后壁髋臼骨折（TPW-AF，p=0.002）、髋臼顶骨折（ARF，p=0.001）、股骨头病变（FHL，p=0.016）、受伤至手术时间（TIS，p＜0.001）和术后体力劳动（PWAS，p＜0.001）。逻辑回归分析显示，TPW-AF（p=0.007，OR=2.610，95%CI：1.302-5.232）、ARF（p=0.001，OR=2.887，95%CI：1.512-5.512）、FHL（p=0.005，OR=2.302，95%CI：1.283-4.131）、TIS（p＜0.0001，OR=1.294，95%CI：1.192-1.405）和 PWAS（p＜0.0001，OR=3.198，95%CI：1.765-5.797）是 PTOA 的独立危险因素。此外，ROC 曲线分析表明，TIS 为 11.5 天可作为预测 PTOA 的截断值。
我们的研究结果表明，TPW-AF、ARF、FHL、TIS 和 PWAS 是 ORIF 治疗 TAF 后发生 PTOA 的独立危险因素。这有助于骨科医生采取早期个体化干预措施，降低其发生率。
