Holy Cross Orthopedic Institute, Holy Cross Health, Fort Lauderdale, Florida; Department of Orthopaedic Surgery, Larkin Community Hospital, South Miami, Florida; Department of Orthopaedic Surgery, Hospital for Special Surgery, West Palm Beach, Florida.
Holy Cross Orthopedic Institute, Holy Cross Health, Fort Lauderdale, Florida.
J Arthroplasty. 2024 Nov;39(11):2820-2823.e1. doi: 10.1016/j.arth.2024.05.074. Epub 2024 May 31.
Pes planus occurs due to the loss of the longitudinal arch of the foot, resulting in altered gait mechanics. This may lead to increased complications following total hip arthroplasty (THA). Thus, the aim of this study was to assess the effects that pes planus has on rates of falls, implant complications, fall-related injuries, and times to revision among THA patients.
A retrospective review of a private insurance claims database was conducted from 2010 to 2021. Patients who had a diagnosis of congenital or acquired pes planus and cases of THA were identified. Patients undergoing THA with a diagnosis of pes planus were matched to control patients 1:5 based on age, sex, and comorbidity profiles. Logistic regression was utilized to assess for differences in complication rates.
A total of 3,622 pes planus patients were matched to 18,094 control patients. The pes planus group had significantly higher rates of falls than the control group (6.93 versus 2.97%, OR [odds ratio]: 2.43; CI [confidence interval]: 2.09 to 2.84; P < .001). Pes planus patients also had significantly greater odds of dislocation (OR: 1.89; CI: 1.58 to 2.27; P < .001), mechanical loosening (OR: 2.43; CI: 2.09 to 2.84; P = .019), and periprosthetic fracture (OR: 2.43; CI: 2.09 to 2.84; P < .001). The pes planus group had significantly greater rates of proximal humerus fractures (P = .008), but no difference was seen in distal radius fractures (P = .102). The time to revision was significantly shorter in the pes planus group (190 versus 554 days, P < .001).
Pes planus in patients undergoing THA is associated with increased risk of complications and faster time to revision. These findings may allow orthopaedic surgeons to identify those patients at risk and allow for more educated patient counseling and operative planning.
平足症是由于足弓丧失，导致步态力学改变。这可能会增加全髋关节置换术（THA）后的并发症。因此，本研究旨在评估平足症对 THA 患者跌倒率、植入物并发症、跌倒相关损伤和翻修时间的影响。
对 2010 年至 2021 年期间的私人保险理赔数据库进行回顾性研究。确定患有先天性或获得性平足症和 THA 病例的患者。将患有平足症并接受 THA 的患者与对照组患者按年龄、性别和合并症情况进行 1:5 匹配。利用逻辑回归评估并发症发生率的差异。
共有 3622 名平足症患者与 18094 名对照组患者相匹配。平足症组的跌倒率明显高于对照组（6.93%比 2.97%，比值比[OR]：2.43；置信区间[CI]：2.09 至 2.84；P<0.001）。平足症患者脱位（OR：1.89；CI：1.58 至 2.27；P<0.001）、机械松动（OR：2.43；CI：2.09 至 2.84；P=0.019）和假体周围骨折（OR：2.43；CI：2.09 至 2.84；P<0.001）的可能性也明显更高。平足症组发生肱骨近端骨折的比例明显更高（P=0.008），但桡骨远端骨折无差异（P=0.102）。平足症组的翻修时间明显更短（190 天比 554 天，P<0.001）。
THA 患者平足症与并发症风险增加和翻修时间提前有关。这些发现可能使骨科医生能够识别出那些有风险的患者，并为患者提供更有针对性的咨询和手术计划。
