Early Complications After One Hundred and Forty-four Consecutive Hip Revisions with Impacted Morselized Allograft Bone and Cement

E. Ornstein, I. Atroshi, H. Franzén, R. Johnsson, P. Sandquist, M. Sundberg
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引用次数: 106

Abstract

Background: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce.Methods: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke). Of these eight patients, seven had a six-week and/or three-month follow-up evaluation.Results: Thirty-nine femoral fractures occurred in thirty-seven hips; twenty-nine of the fractures occurred during surgery and ten, within five months after surgery. Of the intraoperative femoral fractures, twelve were proximal, nine were diaphyseal, and eight involved the greater trochanter. Of the postoperative femoral fractures, one was proximal and nine were diaphyseal. Other intraoperative complications were the creation of a femoral cortical window in seven hips and incidental perforation of the femoral cortex in fourteen. Multivariate analysis showed the risk factors for femoral fracture during or after revision to be concomitant disease, greater deficiency of the femoral bone stock, and an intraoperative femoral window or perforation. Other complications included dislocation of the femoral head in nine hips, deep infection in one hip, persistence of preoperative deep infection in one hip, and superficial wound infection requiring wound débridement in two hips.Conclusions: We found the complication rate to be high after hip revision arthroplasty performed with impacted morselized allograft bone and cement. The most serious complication was postoperative diaphyseal femoral fracture.
144例植入同种异体骨和骨水泥连续髋关节翻修术后的早期并发症
背景:在髋关节翻修成形术中使用嵌套的同种异体骨和骨水泥已经很流行,但是专门针对术中和术后并发症的研究很少。方法:记录144例使用同种异体骨和骨水泥进行的连续髋关节翻修置换术(108例椎体和130例椎体)期间及术后1年内发生的所有并发症。除8例患者(7例死于与髋关节手术无关的原因,1例中风)外,所有患者在手术后3个月和1年进行临床和影像学随访评估。在这8名患者中,7名患者进行了6周和/或3个月的随访评估。结果:37例髋部发生39例股骨骨折;29例骨折发生在手术中,10例发生在手术后5个月内。术中股骨骨折12例为近端骨折,9例为骨干骨折,8例累及股骨大转子。术后股骨骨折1例为近端骨折,9例为骨干骨折。其他术中并发症包括7例髋关节股骨皮质窗口的形成和14例股骨皮质偶然穿孔。多因素分析显示,在翻修术中或翻修后发生股骨骨折的危险因素为合并性疾病、股骨骨缺损较大、术中出现股骨窗或穿孔。其他并发症包括9髋股骨头脱位,1髋深度感染,术前1髋深度感染持续存在,2髋浅表性伤口感染需要进行伤口置换。结论:采用同种异体骨和骨水泥阻生块化行髋关节翻修置换术后并发症发生率高。术后最严重的并发症为股骨干骨折。
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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