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骨科医生对采用骨水泥型髋关节半关节置换术治疗骨折倡议的认知调查

Survey of Orthopedic Surgeons' Perceptions of Adopting an Initiative With Cemented Hip Hemiarthroplasties for Fractures.

作者信息

Curiel Ivette T, Navarro Ronald A, Gill Norman W

机构信息

School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.

The Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.

出版信息

Perm J. 2025 Mar 14;29(1):69-76. doi: 10.7812/TPP/24.140. Epub 2024 Dec 27.

Abstract

INTRODUCTION

Hip hemiarthroplasty is a surgical procedure that requires the adhesion of the prosthetic implant by utilizing a fixation technique, either cemented or noncemented. The current literature does not provide a clear recommendation on a superior technique, although many countries outside the US have guidelines recommending cemented over noncemented procedures. Further, surgeon perceptions and beliefs related to the cemented and noncemented techniques in hip arthroplasty fractures are generally unknown.

METHODS

Orthopedic surgeon leaders adopted a quality assurance initiative to increase the rate of cemented cases within their practice. A survey was developed to capture the surgeons' perceptions related to fixation technique, affordability, and potential barriers and facilitators. Likert scale data were analyzed with descriptive statistics and chi-square tests.

RESULTS

Sixty-one total joint surgeons throughout 13 locations were invited to participate in the study via email. A total of 38 of the 61 total joint surgeons completed the survey, representing a 62% response rate. Most responses were neutral or disagreed with the use of cement for femoral fixation in hemiarthroplasty.

CONCLUSION

Although some questions elicited strong opinions, many surgeons expressed hesitancy to change their current fixation technique and their desire for autonomy within their clinical practices. However, the large number of neutral responses suggests the potential to engage, educate, and shift the surgeons' perception to adopt the quality assurance initiative and increase the rate of cemented cases.

摘要

引言

髋关节半关节置换术是一种外科手术,需要通过使用骨水泥固定或非骨水泥固定技术来实现假体植入物的附着。尽管美国以外的许多国家都有指南推荐采用骨水泥固定而非非骨水泥固定的手术方式,但目前的文献并未就哪种更好的技术给出明确建议。此外,骨科医生对于髋关节置换术骨折中骨水泥固定和非骨水泥固定技术的看法和信念通常并不为人所知。

方法

骨科外科主任采取了一项质量保证措施,以提高其临床实践中采用骨水泥固定病例的比例。开展了一项调查,以了解外科医生对固定技术、可承受性以及潜在障碍和促进因素的看法。使用描述性统计和卡方检验对李克特量表数据进行分析。

结果

通过电子邮件邀请了来自13个地点的61名全关节外科医生参与该研究。61名全关节外科医生中共有38人完成了调查,回复率为62%。大多数回复对于在半关节置换术中使用骨水泥进行股骨固定持中立或反对态度。

结论

尽管一些问题引发了强烈的意见,但许多外科医生表示不愿改变他们目前的固定技术,并且希望在临床实践中有自主权。然而,大量的中立回复表明,有可能促使、教育并改变外科医生的观念,使其采用质量保证措施并提高骨水泥固定病例的比例。

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Comparing Outcomes in Cemented and Press-Fit Hemiarthroplasty.骨水泥型与压配型半关节置换术的疗效比较
J Am Acad Orthop Surg. 2022 Oct 15;30(20):979-983. doi: 10.5435/JAAOS-D-21-01178. Epub 2022 May 10.

本文引用的文献

1
Highlights of the 2023 American Joint Replacement Registry Annual Report.2023年美国关节置换登记处年度报告要点。
Arthroplast Today. 2024 Feb 29;26:101325. doi: 10.1016/j.artd.2024.101325. eCollection 2024 Apr.
3
A Comparison of Risks and Benefits Regarding Hip Arthroplasty Fixation.髋关节置换固定的风险与获益比较。
J Am Acad Orthop Surg Glob Res Rev. 2021 Nov 1;5(11):e21.00014. doi: 10.5435/JAAOSGlobal-D-21-00014.

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