Di Matteo Vincenzo, La Camera Francesco, Carfì Carla, Morenghi Emanuela, Grappiolo Guido, Loppini Mattia
Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy.
Adult Reconstruction and Joint Replacement Service, Division of Orthopedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy.
J Clin Med. 2024 Feb 3;13(3):892. doi: 10.3390/jcm13030892.
The number of patients presenting with periprosthetic hip fractures has increased in recent decades.
Patients who underwent hip revision arthroplasty procedures for Vancouver type B2 and B3 fractures between 2010 and 2021 were included. The primary intended outcome of this study was to determine the reintervention-free survival rate. The secondary intended outcome was to determine clinical and radiographic assessment outcomes at the time of follow-up, and the correlation between time to surgery and postoperative Harris hip score (HHS).
A total of 49 patients with mean age of 71.2 ± 2.3 (37-88) years old were included. Overall, the Kaplan-Meier method estimated a survival rate of 95.8% (CI 84.2% to 98.9%) at one year, 91.1% (CI 77.9% to 96.6%) at two years, and 88.5% (CI 74.4% to 95.1%) at three, and up to 10, years. The mean limb length discrepancy (LLD) improved from -13.3 ± 10.5 (range -39 to +10) mm at the preoperative stage to -1.16 ± 6.7 (range -17 to +15) mm, < 0.001 postoperative. The mean HHS improved from 31.1 ± 7.7 (range 10 to 43) preoperative to 85.5 ± 14.8 (range 60 to 100), < 0.001 postoperative. Postoperative HHS was not affected by preoperative time to surgery.
Revision arthroplasty is an effective treatment for Vancouver type B2 and B3 fractures.
近几十年来，假体周围髋关节骨折患者的数量有所增加。
纳入2010年至2021年间因温哥华B2型和B3型骨折接受髋关节翻修置换手术的患者。本研究的主要预期结果是确定无再次干预生存率。次要预期结果是确定随访时的临床和影像学评估结果，以及手术时间与术后Harris髋关节评分（HHS）之间的相关性。
共纳入49例患者，平均年龄为71.2±2.3（37 - 88）岁。总体而言，Kaplan-Meier方法估计1年时生存率为95.8%（CI 84.2%至98.9%），2年时为91.1%（CI 77.9%至96.6%），3年时为88.5%（CI 74.4%至95.1%），直至10年。平均肢体长度差异（LLD）从术前的-13.3±10.5（范围-39至+10）mm改善至术后的-1.16±6.7（范围-17至+15）mm，P<0.001。平均HHS从术前的31.1±7.7（范围10至43）提高至术后的85.5±14.8（范围60至100），P<0.001。术后HHS不受术前手术时间的影响。
翻修置换术是治疗温哥华B2型和B3型骨折的有效方法。
