Department of Orthopaedics and Traumatology, Harran University, Faculty of Medicine, Şanlıurfa, Türkiye.
Department of Orthopaedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye.
Clin Orthop Surg. 2024 Aug;16(4):602-609. doi: 10.4055/cios23397. Epub 2024 Jul 12.
This study evaluated national trends in cemented and uncemented reverse shoulder arthroplasty (RSA) for proximal humerus fractures using a comprehensive national surgical database. This study aimed to compare RSA used in the treatment of proximal humerus fractures with the literature and to determine the country's trend.
A cross-sectional study was conducted using the health records of individuals aged ≥ 18 years who underwent RSA for proximal humerus fractures between 2016 and 2022. Patients were divided into cemented and uncemented groups, and demographic data (age, sex), duration of hospital stay, transfusions, revisions, mortality, and Charlson Comorbidity Index (CCI) scores were analyzed.
A total of 618 cemented RSA and 1,364 uncemented RSA procedures were reviewed. Patients who underwent cemented RSA were significantly older than those who had uncemented RSA ( = 0.002). Transfusion rates were higher in the cemented RSA group ( = 0.006). The frequency of revision surgery was 6.1%. Younger age and male sex were associated with revision ( < 0.001). CCI scores were higher among transfused patients than non-transfused patients ( < 0.001). The incidence of cemented RSA was 11.7% and 49% in 2016 and 2022, respectively. Differences were found among hospital types and geographical regions.
While cemented RSA has been gaining attention and increased application in recent years for proximal humerus fractures, uncemented RSA still predominates. The choice between these 2 methods is largely influenced by regional and hospital-level factors. The type of RSA and high CCI scores were found to have no significant impact on the risk of surgical revision.
本研究使用全面的国家手术数据库评估了全髋关节置换术治疗股骨颈骨折的全国趋势。本研究旨在比较全髋关节置换术治疗股骨颈骨折的应用情况，并确定全国趋势。
采用回顾性队列研究方法，收集 2016 年至 2022 年期间接受全髋关节置换术治疗股骨颈骨折的≥18 岁患者的健康记录。患者分为骨水泥型和非骨水泥型两组，分析其人口统计学数据（年龄、性别）、住院时间、输血、翻修、死亡率和 Charlson 合并症指数（CCI）评分。
共回顾了 618 例骨水泥型全髋关节置换术和 1364 例非骨水泥型全髋关节置换术。骨水泥型全髋关节置换术患者明显比非骨水泥型全髋关节置换术患者年龄大（=0.002）。骨水泥型全髋关节置换术组的输血率较高（=0.006）。翻修手术的频率为 6.1%。年龄较小和男性与翻修相关（<0.001）。输血患者的 CCI 评分高于未输血患者（<0.001）。2016 年和 2022 年骨水泥型全髋关节置换术的发生率分别为 11.7%和 49%。不同医院类型和地理区域之间存在差异。
尽管近年来骨水泥型全髋关节置换术在股骨颈骨折中的应用越来越受到关注，但非骨水泥型全髋关节置换术仍占主导地位。这两种方法的选择在很大程度上受到地区和医院级别的因素影响。研究未发现全髋关节置换术的类型和高 CCI 评分对手术翻修风险有显著影响。
