Singh Amit, Singh Abhimanyu, Gotecha Dhaval, Gandavaram Srikanth, Patel Kuntal, Herlekar Deepak
Orthopaedics and Traumatology, Royal Lancaster Infirmary, Lancaster, GBR.
Orthopaedics and Trauma, Royal Lancaster Infirmary, Lancaster, GBR.
Cureus. 2025 Mar 11;17(3):e80399. doi: 10.7759/cureus.80399. eCollection 2025 Mar.
Background It is widely acknowledged that bone cement may infiltrate the fracture site during the implantation of a cemented hip stem for a periprosthetic fracture, potentially leading to non-union. This study sought to examine this hypothesis through a radiological analysis of patients who underwent cemented femoral stem implantation to stabilize a periprosthetic femur fracture or after a cortical osteotomy for stem extraction. Methodology A retrospective study was conducted from 2015 to 2020 at a specialist center in the United Kingdom. Patients over 18 years old receiving cemented femoral stems for periprosthetic fractures or following cortical osteotomies were included. Bone healing was assessed through serial radiographs. Results The study included 25 patients with a mean age of 82.2 years and a female-to-male ratio of 16:9. Overall, 19 (76%) and 6 (24%) patients, respectively, received cemented femoral stems following a periprosthetic fracture revision or a cortical osteotomy used during revision. No bone grafts were used for any of the patients. Unfortunately, two patients were lost to follow-up, and five patients in the fracture group died before their fractures had united. The remaining 12 fractures healed in an average of 2.2 months, while all six cortical osteotomies healed in an average of 4.2 months. Conclusions Our research findings demonstrate the efficacy of employing a cemented femoral stem in revision hip arthroplasty scenarios involving periprosthetic femur fractures or cortical osteotomies, as it does not adversely affect bone healing.
背景 人们普遍认为,在为假体周围骨折植入骨水泥型髋关节柄时,骨水泥可能会渗入骨折部位,这可能导致骨折不愈合。本研究旨在通过对接受骨水泥型股骨柄植入以稳定假体周围股骨骨折或在进行皮质截骨以取出股骨柄后患者的影像学分析来检验这一假设。
方法 2015年至2020年在英国一家专科中心进行了一项回顾性研究。纳入年龄超过18岁、因假体周围骨折或皮质截骨后接受骨水泥型股骨柄植入的患者。通过系列X线片评估骨愈合情况。
结果 该研究纳入了25例患者,平均年龄82.2岁,女性与男性比例为16:9。总体而言,分别有19例(76%)和6例(24%)患者在假体周围骨折翻修或翻修期间进行皮质截骨后接受了骨水泥型股骨柄植入。所有患者均未使用骨移植。遗憾的是,2例患者失访,骨折组中有5例患者在骨折愈合前死亡。其余12例骨折平均在2.2个月愈合,而所有6例皮质截骨平均在4.2个月愈合。
结论 我们的研究结果表明,在涉及假体周围股骨骨折或皮质截骨的髋关节翻修手术中使用骨水泥型股骨柄是有效的,因为它不会对骨愈合产生不利影响。