Luger Matthias, Gotterbarm Tobias, Schopper Clemens
Klinik für Orthopädie & Traumatologie, Kepler Universitätsklinikum GmbH, Johannes Kepler Universität Linz, Krankenhausstraße 9, 4020, Linz, Österreich.
, Altenberger Straße 69, 4040, Linz, Österreich.
Orthopadie (Heidelb). 2025 May 21. doi: 10.1007/s00132-025-04658-z.
Periprosthetic acetabular fractures primarily pose a problem with cementless implantation techniques and occur in approximately 3.6% of primary and up to 20.9% of revision cases. When a fracture situation exists that affects the integrity of the pelvic columns, stabilization using plate osteosynthesis is necessary, in addition to the implantation of a revision cup. Periprosthetic femoral fractures also primarily occur with cementless techniques and account for 0.4-6.8% of revisions after primary total hip arthroplasty. In addition to the cementless technique, the most common risk factors for the development of PFF are a minimally invasive, ventral approach, female gender, poor bone quality, age > 75 years, and revision surgery.
Depending on the degree of risk to the stability of the implant, conservative or surgical treatment can be carried out using osteosynthesis, stem replacement or a combination of both procedures.
髋臼假体周围骨折主要在非骨水泥植入技术中出现问题,在初次手术病例中发生率约为3.6%,在翻修病例中高达20.9%。当存在影响骨盆柱完整性的骨折情况时,除了植入翻修髋臼杯外,还需要使用钢板接骨术进行稳定固定。股骨假体周围骨折也主要发生于非骨水泥技术中,占初次全髋关节置换术后翻修病例的0.4 - 6.8%。除了非骨水泥技术外,发生假体周围骨折最常见的风险因素包括微创、前路入路、女性、骨质不佳、年龄>75岁以及翻修手术。
根据植入物稳定性的风险程度,可采用接骨术、柄置换或两者结合的方式进行保守或手术治疗。