Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia.
Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia.
J Arthroplasty. 2025 Jan;40(1):169-174. doi: 10.1016/j.arth.2024.07.008. Epub 2024 Jul 11.
Total hip arthroplasty (THA) is an effective surgical treatment for severe osteoarthritis of the hip. While THA is considered a reliable and safe procedure, outcome data on patients who have Ehlers-Danlos syndrome (EDS) is limited. The purpose of this study was to compare rates of postoperative complications after primary THA in patients who have EDS against matched controls.
A large national database was searched to identify patients who underwent THA between 2009 and 2020. Patients younger than 18 years, those who have a history of prior THA, and those undergoing THA for a hip fracture were excluded from analysis. Propensity score matching was utilized to match patients who had EDS with patients who did not have EDS at a 1:4 ratio. Rates of medical and surgical complications at 90 days and 2 years were queried and compared between the cohorts using multivariable logistic regression. We identified 118 patients who had EDS and underwent primary THA, who were then matched with 418 controls.
At 90 days, the EDS cohort had greater rates of dislocation (8.5 versus 3.8%, P = 0.038). At 2 years, the EDS cohort had greater odds of dislocation (OR [odds ratio] 2.47, P = 0.018), aseptic loosening (OR 6.91, P = 0.002), and aseptic revision (OR 2.66, P = 0.02).
Patients who have EDS possess significantly higher odds of complications after THA compared to matched controls, including dislocation, aseptic loosening, and aseptic revision. Careful surgical planning in these patients should be made to prevent dislocation and potentially minimize the risk of other prosthesis-related complications leading to revision.
全髋关节置换术（THA）是治疗髋关节严重骨关节炎的有效手术治疗方法。虽然 THA 被认为是一种可靠且安全的手术，但患有埃勒斯-当洛斯综合征（EDS）的患者的术后结果数据有限。本研究的目的是比较 EDS 患者与匹配对照组在初次 THA 后术后并发症的发生率。
在全国范围内搜索了一个大型数据库，以确定 2009 年至 2020 年间接受 THA 的患者。排除年龄小于 18 岁、有既往 THA 史以及因髋部骨折接受 THA 的患者。利用倾向评分匹配，以 1:4 的比例将 EDS 患者与没有 EDS 的患者进行匹配。在 90 天和 2 年时，查询并比较了两组的医疗和手术并发症发生率，并使用多变量逻辑回归进行了比较。我们确定了 118 名患有 EDS 并接受初次 THA 的患者，然后将其与 418 名对照者进行匹配。
在 90 天时，EDS 组的脱位率更高（8.5%比 3.8%，P=0.038）。在 2 年时，EDS 组的脱位率更高（OR [比值比] 2.47，P=0.018）、无菌性松动（OR 6.91，P=0.002）和无菌性翻修（OR 2.66，P=0.02）的可能性更大。
与匹配的对照组相比，患有 EDS 的患者在接受 THA 后发生并发症的几率明显更高，包括脱位、无菌性松动和无菌性翻修。在这些患者中应进行仔细的手术计划，以防止脱位，并可能最大限度地降低导致翻修的其他假体相关并发症的风险。
