Okur Kürşat Tuğrul, Özdemir Koray, Sarıaslan Ahmet Yesevi, Ozan Fırat
Department of Orthopaedics and Traumatology, Yozgat Sorgun State Hospital, Ahmet Efendi Mah. Şehit Cemal Şimşek Cad. No 37, Yozgat, Turkey.
Department of Orthopaedics and Traumatology, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
BMC Musculoskelet Disord. 2025 Feb 5;26(1):120. doi: 10.1186/s12891-025-08364-x.
Increasing life expectancy has led to a rise in hip fractures and an associated increase in hemiarthroplasty procedures aimed at restoring mobility and preventing muscle loss. Despite the extensive literature on failed hemiarthroplasty, limited data address the influence of pre-operative fracture types-intracapsular versus extracapsular-on outcomes, including inpatient mortality. This study investigates the revisions of uncemented bipolar hemiarthroplasties concerning fracture type and identifies risk factors for inpatient mortality.
This retrospective cohort study included 68 patients (16 males and 52 females) who underwent revision of uncemented bipolar hemiarthroplasties at a single institution between 2017 and 2024. Data on demographics, comorbidities, fracture type, surgical details and outcomes were analysed. Statistical analyses included t tests, chi-square tests and logistic regression, with significance set at p < 0.05.
Of 1,690 hemiarthroplasties performed, 68 required revision (revision rate: 4%). Revisions for extracapsular fractures were associated with a higher prevalence of diabetes mellitus (p = 0.01) and elevated Almelo Hip Fracture Score (AHFS; p = 0.01). The overall inpatient mortality rate was 19%, significantly higher in males (43.75%) than females (11.54%; p = 0.00). Deceased patients demonstrated higher AHFS and American Society of Anaesthesiologists scores but lower Parker Mobility Scores (p = 0.01). Prolonged intensive care unit (ICU) stays were also linked to increased mortality (p = 0.02). Logistic regression identified male sex as an independent predictor of mortality (odds ratio: 9.37; p < 0.05).
Pre-operative fracture type significantly influences revision outcomes in failed hemiarthroplasties. Moreover, extracapsular fractures are linked to diabetes mellitus and higher AHFS, whereas male sex, ICU stay duration and comorbidity scores predict inpatient mortality. These findings highlight the need for tailored perioperative care to mitigate risks.
Not applicable.
预期寿命的延长导致髋部骨折数量增加，同时旨在恢复活动能力和预防肌肉流失的半髋关节置换手术数量也相应增加。尽管关于半髋关节置换失败的文献众多，但针对术前骨折类型（囊内骨折与囊外骨折）对包括住院死亡率在内的手术结果的影响的数据有限。本研究调查了非骨水泥型双极半髋关节置换术因骨折类型导致的翻修情况，并确定了住院死亡率的危险因素。
这项回顾性队列研究纳入了2017年至2024年间在单一机构接受非骨水泥型双极半髋关节置换术翻修的68例患者（16例男性和52例女性）。分析了人口统计学、合并症、骨折类型、手术细节和手术结果等数据。统计分析包括t检验、卡方检验和逻辑回归，显著性设定为p < 0.05。
在进行的1690例半髋关节置换术中，68例需要翻修（翻修率：4%）。囊外骨折翻修与糖尿病患病率较高（p = 0.01）和阿尔梅洛髋部骨折评分（AHFS）升高（p = 0.01）相关。总体住院死亡率为19%，男性（43.75%）显著高于女性（11.54%；p = 0.00）。死亡患者的AHFS和美国麻醉医师协会评分较高，但帕克活动评分较低（p = 0.01）。重症监护病房（ICU）住院时间延长也与死亡率增加有关（p = 0.02）。逻辑回归确定男性为死亡率的独立预测因素（比值比：9.37；p < 0.05）。
术前骨折类型显著影响失败的半髋关节置换术的翻修结果。此外，囊外骨折与糖尿病和较高的AHFS相关，而男性、ICU住院时间和合并症评分可预测住院死亡率。这些发现凸显了需要进行针对性的围手术期护理以降低风险。
不适用。
