Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, Virginia; Department of Orthopaedic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.
Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
J Arthroplasty. 2024 Jun;39(6):1535-1544. doi: 10.1016/j.arth.2023.12.029. Epub 2023 Dec 21.
Osteonecrosis of the femoral head (ONFH) affects both young and old patients. However, outcomes following total hip arthroplasty (THA) for these patients may vary with age. This study aimed to examine the effect of age on THA outcomes for non-traumatic ONFH patients, an area currently lacking research.
Patients who had non-traumatic ONFH undergoing THA with at least 2 years of follow-up were identified using a database and divided into four groups by age. Then, 4 matched control groups of patients who had hip osteoarthritis (OA) were created. Multivariate logistic regression analyses were used to evaluate the rates of medical and surgical complications. Additionally, cohorts with a minimum 5-year follow-up were filtered to obtain further data on surgical outcomes. The study analyzed 85,462 non-traumatic ONFH and 80,120 hip OA patients undergoing THA.
Multiple medical complications in ONFH patients increased with age. Periprosthetic fracture within 2 years increased with age, while 90-day wound complications, 2-year periprosthetic joint infections, dislocations, and revisions decreased. The trends for complications continued at the 5-year follow-up. Compared to OA patients, those who had ONFH had higher risks of most complications, but this discrepancy decreased with age.
In ONFH patients undergoing THA, medical complications generally rise with age, while most surgical complications, including revisions, decrease. It is notable that ONFH patients experienced more complications than those who had OA, but this difference diminished with age.
股骨头坏死（ONFH）影响年轻和老年患者。然而，这些患者接受全髋关节置换术（THA）的结果可能因年龄而异。本研究旨在探讨年龄对非创伤性 ONFH 患者 THA 结果的影响，这是一个目前缺乏研究的领域。
使用数据库确定了接受 THA 治疗且至少有 2 年随访的非创伤性 ONFH 患者，并按年龄分为四组。然后，创建了 4 组与髋骨关节炎（OA）患者相匹配的对照组。采用多变量逻辑回归分析评估医疗和手术并发症的发生率。此外，还筛选了具有至少 5 年随访的队列，以获取有关手术结果的进一步数据。本研究共分析了 85462 例非创伤性 ONFH 和 80120 例髋 OA 患者接受 THA 的情况。
ONFH 患者的多种医疗并发症随年龄增加而增加。2 年内发生假体周围骨折的风险随年龄增加而增加，而 90 天伤口并发症、2 年假体周围关节感染、脱位和翻修的风险则降低。这种趋势在 5 年随访时仍在继续。与 OA 患者相比，ONFH 患者发生大多数并发症的风险更高，但这种差异随年龄减小。
在接受 THA 的 ONFH 患者中，医疗并发症通常随年龄增加而增加，而大多数手术并发症（包括翻修）则减少。值得注意的是，ONFH 患者比 OA 患者经历了更多的并发症，但这种差异随年龄减小。
