与传统关节置换相比，初次全髋关节置换术中双动髋臼组件不会增加并发症风险：一项匹配队列对比分析。
Dual-Mobility Acetabular Components in Primary Total Hip Arthroplasty Do Not Increase the Risk of Complication Compared to Conventional Articulations: A Matched Cohort Comparative Analysis.
作者信息
Khaliq Mehnoor, Jenkins Neesha, Van Duren Bernard, Palan Jeya, Pandit Hemant, Jain Sameer
机构信息
Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.
出版信息
Arthroplast Today. 2024 Feb 26;26:101332. doi: 10.1016/j.artd.2024.101332. eCollection 2024 Apr.
BACKGROUND
A recent National Joint Registry report suggests a higher local complication risk for dual-mobility (DM) total hip arthroplasty (THA) compared to conventional articulation THA. This report may be subject to data heterogeneity with multiple confounders. Controlling for these factors by matching demographic characteristics may give different results. We aim to compare 2-year local complication rates between matched DM and conventional THAs in primary hip osteoarthritis.
METHODS
Data were collected for consecutive primary THAs undertaken via a posterior approach. The conventional articulation and DM cohorts were matched 3:1 for age, gender, American Society of Anesthesiology grade, body mass index, and operative time using a propensity score and nearest neighbor matching method. Outcome measures were 2-year local complication rates, reoperation rates, systemic complication rates, and mortality rates. Demographic and outcome data were compared, and cumulative survival rates (%) were assessed using Kaplan-Meier methodology with a 2-year local complication as the endpoint. Statistical significance was set at < .05.
RESULTS
Four hundred twelve THAs were included: 309 conventional and 103 DM articulations. There were no statistically significant differences between DM and conventional articulation THAs for local complications (7 [6.8%] vs 23 [7.4%], = .820), reoperations (3 [2.9%] vs 4 [1.3%], = .374), systemic complications (3 [2.9%] vs 4 [1.3%], = .374), or 90-day mortality (1 [1%] vs 2 [0.6%], = 1.000). Kaplan-Meier survival analysis demonstrated similar 2-year survival rates for conventional THAs compared to DM THAs (93.3% [standard error, 0.014] vs 91.9% [standard error, 0.031], = .906).
CONCLUSIONS
This matched study shows that there is no difference in local complication rates between DM and conventional THA articulations.
背景
国家关节注册中心最近的一份报告显示，与传统关节置换全髋关节置换术（THA）相比，双动（DM）全髋关节置换术的局部并发症风险更高。该报告可能存在数据异质性以及多种混杂因素。通过匹配人口统计学特征来控制这些因素可能会得出不同的结果。我们旨在比较原发性髋骨关节炎中匹配的DM和传统THA的2年局部并发症发生率。
方法
收集通过后入路进行的连续原发性THA的数据。使用倾向评分和最近邻匹配方法，将传统关节置换组和DM组按年龄、性别、美国麻醉医师协会分级、体重指数和手术时间进行3:1匹配。观察指标为2年局部并发症发生率、再次手术率、全身并发症发生率和死亡率。比较人口统计学和观察指标数据，并使用Kaplan-Meier方法评估累积生存率（%），以2年局部并发症为终点。统计学显著性设定为<0.05。
结果
共纳入412例THA：309例传统关节置换和103例DM关节置换。DM和传统关节置换THA在局部并发症（7 [6.8%] 对23 [7.4%]，P = 0.820）、再次手术（3 [2.9%] 对4 [1.3%]，P = 0.374）、全身并发症（3 [2.9%] 对4 [1.3%]，P = 0.374）或90天死亡率（1 [l%] 对2 [0.6%]，P = 1.000）方面无统计学显著差异。Kaplan-Meier生存分析显示，与DM THA相比，传统THA的2年生存率相似（93.3% [标准误差，0.014] 对91.9% [标准误差，0.031]，P = 0.906）。
结论
这项匹配研究表明，DM和传统THA关节置换的局部并发症发生率没有差异。
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