Department of Traumatology and Orthopedics of Adults, Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine, Kyiv, 01601, Ukraine.
Department of Traumatology and Orthopedics, Bogomolets National Medical University, Kyiv, 01601, Ukraine.
BMC Surg. 2024 Oct 21;24(1):322. doi: 10.1186/s12893-024-02631-9.
The objective of this study is to organise data on complications following total hip replacement (THA) over a span of 10 years, specifically focussing on cases that necessitated revision endoprosthetic surgeries. The objective is to create a recommendation for an All-Ukrainian registry of initial and repeated hip arthroplasty (HA) and standardise the terminology used to define "revision of total hip replacement surgery".
The retrospective analysis examined 236 instances of revision hip arthroplasty (rTHA) performed at the Institute of Traumatology and Orthopaedics Centre between January 2005 and December 2021. The primary factors for revision were identified through an analysis of the patient's medical records, laboratory results, visual inspection, and the state of the previously implanted prosthesis. Demographic information, primary and revision HA dates, diagnoses, and causes of complications were recorded. The statistical analysis was conducted using the Statistica package (StatSoft), version 12.6 (2015), with a significance level of p < 0.05.
Out of the 364 patients who were diagnosed with complications, 236 of them (55.17%) needed a procedure called 1rTHA. Among these cases, 152 (41.76%) were specifically diagnosed with aseptic component instability. Significant factors for mechanical loosening were a high body mass index (BMI ≥ 30) and older age, with respective t-values of 2.08 (p = 0.004) and 2.59 (p = 0.045). Osteoporosis significantly contributed to aseptic loosening and fractures around the implant. The occurrence of infectious complications was frequently linked to chronic infectious diseases (t = 3.37, p = 0.001). The overall percentage of need for 2rTHA was 27.22% (43 cases), with one case of infectious lesion following the revision.
The study emphasises the urgent requirement for standardised terminology and a comprehensive registry for hip arthroplasty procedures. Primary results indicate that cement-free fixation is more effective than cement-based fixation for revision in patients with aseptic instability and that two-stage arthroplasty is effective for treating infectious inflammation. Furthermore, the most effective treatment for femoral fractures with periprosthetic involvement was determined to be open repositioning and osteosynthesis with metal retainers. The aforementioned observations emphasise the need to create a comprehensive registry across Ukraine to support patient care, enable evidence-based practices, and enhance the overall effectiveness of hip arthroplasty operations.
Not applicable.
本研究旨在对 10 年间全髋关节置换术（THA）后并发症的数据进行整理，重点关注需要翻修的病例。目的是为乌克兰初次和翻修髋关节置换术（HA）的注册制定建议，并规范“全髋关节翻修术”定义的术语。
本回顾性分析研究了 2005 年 1 月至 2021 年 12 月在创伤与矫形中心研究所进行的 236 例翻修髋关节置换术（rTHA）病例。通过对患者病历、实验室结果、肉眼观察和先前植入假体的状态进行分析，确定翻修的主要因素。记录了人口统计学信息、初次和翻修 HA 的日期、诊断和并发症的原因。统计分析使用 Statistica 软件包（StatSoft），版本 12.6（2015 年），显著性水平为 p<0.05。
在 364 名被诊断为并发症的患者中，有 236 名（55.17%）需要进行 1rTHA 手术。在这些病例中，有 152 例（41.76%）被明确诊断为无菌性部件不稳定。机械松动的显著因素是高体重指数（BMI≥30）和年龄较大，相应的 t 值分别为 2.08（p=0.004）和 2.59（p=0.045）。骨质疏松症显著导致无菌性松动和植入物周围骨折。感染性并发症的发生常与慢性传染病有关（t=3.37，p=0.001）。需要 2rTHA 的总体百分比为 27.22%（43 例），其中一例为翻修后感染性病变。
本研究强调了对髋关节置换术标准化术语和综合登记的迫切需求。初步结果表明，在无菌性不稳定的患者中，无水泥固定比水泥基固定更有效，两阶段关节置换术对治疗感染性炎症有效。此外，对于伴有假体周围受累的股骨骨折，最有效的治疗方法是切开复位和金属固定器骨内固定。上述观察结果强调了在乌克兰建立一个全面的登记处的必要性，以支持患者护理，实施基于证据的实践，并提高髋关节置换术的整体效果。
不适用。
