Fracture of femoral neck in modular total hip arthroplasty: a systematic review of the literature.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-05-01 Epub Date: 2023-11-06 DOI:10.1177/11207000231211253
Konstantina Solou, Andreas Panagopoulos, Irini Tatani, Panagiotis Megas
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引用次数: 0

Abstract

Background: Modular femoral stems have the advantage of anatomic hip reconstruction by restoring the femoral offset thus minimising the bearing surface wear, implant loosening and dislocation.

Aim: This study aims to investigate the existing literature on modular neck fractures, to identify predisposing factors and guide the decision-making process in the management of these difficult cases.

Methods: A systematic literature review was conducted until July 2022. PRISMA guidelines were followed, eligibility criteria were set, and methodology assessment of included studies was conducted based on MINORS criteria, size and primary outcome. Data were extracted and analysed thoroughly.

Results: 5657 studies were initially screened; the full texts of 124 records were assessed and finally, 32 reports were included. There were 7 clinical studies and 25 case reports. A total of 4825 patients (5204 hips) with a mean age 62.38 years and a mean BMI 29.06 kg/m2 were analysed in the 7 clinical studies. The reported overall weighted revision rate was 0.86%, while the weighted mean modular neck fracture rate was 0.26%. The usual history was sudden experience of hip pain and instability. The average time interval to neck fracture was 4.57 (range 3-4.7) years and a long modular neck was identified in 91.17% of them. Data from case reports showed a mean age and average BMI of 55.85 and 31.63 kg/m2. 82.35% of the patients were male. Necks were fractured after an average time interval of 64.5 ± 8.8 months.

Conclusions: The incidence of modular neck fracture is significant. The profile of a male, obese patient with a long modular neck increased risk of neck fracture. Microstructural investigation of the retrieved implants demonstrated a higher incidence of fracture line in the base of the neck junction and at its anterolateral distal part. Surgeons should be aware of this complication while using or revising such protheses.

模块化全髋关节置换术中股骨颈骨折:文献系统回顾。
背景:模块化股骨干具有解剖髋关节重建的优势,通过恢复股骨偏移,从而最大限度地减少支承面磨损、植入物松动和脱位。目的:本研究旨在调查现有关于模块化颈部骨折的文献,以确定易感因素,并指导这些疑难病例的决策过程。方法:进行系统的文献综述,直到2022年7月。遵循PRISMA指南,制定资格标准,并根据MINORS标准、规模和主要结果对纳入研究进行方法评估。对数据进行了彻底的提取和分析。结果:初步筛选5657项研究;对124份记录的全文进行了评估,最终纳入32份报告。共有7项临床研究和25例病例报告。共有4825名患者(5204髋),平均年龄62.38岁 年,平均BMI 29.06 在7项临床研究中分析了kg/m2。报告的整体加权翻修率为0.86%,而加权平均模块化颈部骨折率为0.26%。通常的病史是突然经历髋关节疼痛和不稳定。颈部骨折的平均时间间隔为4.57年(范围3-4.7年),91.17%的患者发现了长的模块化颈部。病例报告的数据显示,平均年龄和平均BMI分别为55.85和31.63 82.35%的患者为男性。颈部骨折的平均时间间隔为64.5 ± 8.8 月。结论:模块化颈部骨折的发生率较高。一名男性肥胖患者的长模块化颈部增加了颈部骨折的风险。对回收植入物的微观结构研究表明,颈交界处底部及其前外侧远端的骨折线发生率较高。外科医生在使用或翻修此类假体时应注意这种并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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