Robinson Richard M, Lynch Wong Matthew, Cassidy Roslyn, Lamb Jonathan, Karayiannis Paul N, Diamond Owen, Beverland David
Musgrave Park Hospital, Belfast, UK.
Bone Joint J. 2025 May 1;107-B(5 Supple A):82-86. doi: 10.1302/0301-620X.107B5.BJJ-2024-1113.R1.
We set out to determine, when using either the collared Corail cementless stem or the Exeter polished taper-slip cemented stem, the incidence of intraoperative periprosthetic femoral fracture (IOPFF), postoperative periprosthetic femoral fracture (POPFF), and femoral prosthetic fracture.
This was a retrospective review of a consecutive series of 11,018 total hip arthroplasties (THAs) over a ten-year period (January 2010 to February 2020). Fractures were identified using an exhaustive review of regional radiograph archiving and electronic care systems.
Of the total stems, 4,952 were Corail and 6,066 Exeter designs. There were no differences in age, sex, and BMI between groups. There was a greater incidence of IOPFF with the Corail (42 Corail vs 11 Exeter; p < 0.001). Three patients in each group had a femoral shaft fracture; the remaining fractures were either the calcar (20 Corail and two Exeter) or the greater trochanter (11 Corail and six Exeter). Overall, there was no difference in the rate of POPFF (p = 0.345). However, POPFF in males was greater with the Exeter (p < 0.001), and significantly more Exeter POPFFs required a reoperation (p < 0.001). There were five (0.08%) Exeter stem fractures and none with the Corail implant.
There were significantly more IOPFFs with Corail, which occurred in the calcar or greater trochanter, but these had no impact on early recovery or one-year Oxford Hip Scores. Males with the Exeter stem had a five-times greater risk of having a reoperation for POPFF. Females had the same risk of reoperation for fracture with either component. Femoral prosthetic fractures only occurred with the Exeter stem. These results represent robust estimates, which are likely to be more accurate than revision-only studies typically generated from registry data.
我们旨在确定在使用带颈圈的Corail非骨水泥型股骨柄或埃克塞特抛光锥形滑移骨水泥型股骨柄时，术中假体周围股骨骨折（IOPFF）、术后假体周围股骨骨折（POPFF）以及股骨假体骨折的发生率。
这是一项对连续11,018例全髋关节置换术（THA）进行的回顾性研究，研究时间跨度为十年（2010年1月至2020年2月）。通过全面审查区域放射照片存档和电子护理系统来识别骨折情况。
在所有股骨柄中，4,952个是Corail型，6,066个是埃克塞特型。两组在年龄、性别和体重指数方面没有差异。Corail型的IOPFF发生率更高（42例Corail型 vs 11例埃克塞特型；p < 0.001）。每组有3例患者发生股骨干骨折；其余骨折部位为股骨距（20例Corail型和2例埃克塞特型）或大转子（11例Corail型和6例埃克塞特型）。总体而言，POPFF发生率没有差异（p = 0.345）。然而，男性中埃克塞特型的POPFF发生率更高（p < 0.001），并且埃克塞特型的POPFF需要再次手术的情况明显更多（p < 0.001）。有5例（0.08%）埃克塞特型股骨柄骨折，而Corail型植入物未发生骨折。
Corail型的IOPFF明显更多，发生在股骨距或大转子部位，但这些对早期恢复或一年牛津髋关节评分没有影响。使用埃克塞特型股骨柄的男性因POPFF进行再次手术的风险高五倍。女性使用两种假体进行骨折再次手术的风险相同。股骨假体骨折仅发生在埃克塞特型股骨柄。这些结果是可靠的估计，可能比通常从登记数据中得出的仅关于翻修的研究更准确。
