摘要
目的探讨老年全髋关节置换术后发生假体周围骨折的危险因素,为临床预防该类型疾病提供指导意见。方法回顾性分析2013年1月—2017年12月新疆医科大学第六附属医院骨病矫形外科行全髋关节置换手术治疗且发生假体周围骨折患者25例为骨折组,男性10例,女性15例;年龄60~81岁,平均70.0岁。另选取同期手术且未发生假体周围骨折患者100例为配对(年龄、性别匹配)研究的对照组。统计两组患者年龄、性别、体质量指数(BMI)、合并疾病、Garden分型、假体类型、手术入路、是否伴有骨质疏松、是否伴有术后髋部感染病史、股骨近端髓腔形态等资料,采用条件Logistic回归分析法探讨全髋关节置换术后发生假体周围骨折的危险因素。结果两组患者年龄、性别、吸烟、饮酒、BMI、Garden分型、手术入路、是否伴有术后髋部感染病史比较,差异无统计学意义(P>0.05);两组患者高血压、糖尿病、贫血合并率比较,差异有统计学意义(P<0.05);骨折组假体类型、骨质疏松、股骨近端髓腔形态与对照组比较,差异有统计学意义(P<0.05)。Logistic回归模型结果显示合并糖尿病、伴有骨质疏松、生物型假体、股骨近端非正常髓腔形态是患者髋关节置换术后发生假体周围骨折的独立危险因素(P<0.05)。结论全髋关节置换术后发生假体周围骨折的危险因素较多,伴有骨质疏松、生物型假体、股骨近端非正常髓腔形态会增大患者发生假体周围骨折的风险。
Objective To explore the risk factors that cause recurrence of periprosthetic fractures after total hip arthroplasty and provide guidance for clinical prevention of this type of patients.Methods A retrospective analysis was conducted in 25 patients who underwent total hip replacement and re-fractures around the prosthesis from Jan.2013 to Dec.2017 in the Department of Orthopedics and of the Sixth Affiliated Hospital of Xinjiang Medical University,who were classified as the fracture group.There were 10 males and 15 females,with an average age of 70.0 years(range,60-81 years).In addition,100 patients who had undergone surgery during the same period and did not have fractures around the prosthesis were selected as the control group(age,gender-matched).Data such as age,gender,body mass index(BMI),comorbidities,Garden classification,prosthesis type,surgical approach,whether accompanied by osteoporosis,whether accompanied by a history of hip infection,and the medullary cavity of the proximal femur were statistically analyzed,and the conditional logistic regression analysis method was used to investigate the risk factors of periprosthetic fractures after total hip arthroplasty.Results There was no significant difference in age,gender,smoking,drinking,BMI,Garden classification,surgical approach,or history of hip infection between the fracture group and the control group(P>0.05).Comparison of the combined rates of hypertension,diabetes and anemia between the fracture group and the control group showed statistically significant difference(P<0.05).Compared with the control group,the proportion of patients with prosthesis type,osteoporosis,and medullary cavity morphology of the proximal femur in the fracture group was statistically significant(P<0.05).Logistic regression model results showed that diabetes,associated osteoporosis,bioprosthesis,and abnormal medullary cavity morphology of the proximal femur were independent risk factors for patients with periprosthetic fractures after hip replacement(P<0.05).Conclusion There are many risk factors for recurring fractures around the prosthesis after total hip replacement.The associated osteoporosis,biological prosthesis,and abnormal medullary cavity morphology of the proximal femur will increase the risk of patients with fractures around the prosthesis.
作者
李璐兵
阿依丁·夏哈太
李飞
韩然
Li Lubing;A yiding·Xia hatai;Li Fei;Han Ran(Department of Orthopaedic Surgery,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,China;International Ward Orthopaedic Group,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,China)
出处
《创伤外科杂志》
2021年第10期740-743,748,共5页
Journal of Traumatic Surgery
关键词
全髋关节置换
假体周围骨折
危险因素
老年
total hip replacement
periprosthetic fracture
risk factors
elderly
