Peter P Schmitz, Gerjon Hannink, Matthijs P Somford, B Willem Schreurs, Job L C Van Susante
{"title":"股骨颈骨折后修复与急性全髋关节置换术的翻修风险比较:来自荷兰关节置换术登记的分析。","authors":"Peter P Schmitz, Gerjon Hannink, Matthijs P Somford, B Willem Schreurs, Job L C Van Susante","doi":"10.2340/17453674.2023.17743","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>There is no consensus on the treatment of patients with femoral neck fractures between internal fixation (IF) or directly treated with a total hip arthroplasty (fracture-THA) in particular for the age group 60-70 years. Failure of IF is not uncommon, resulting in salvage total hip arthroplasty (salvage-THA). The aim of our study was to compare revision rates of salvage-THA with fracture-THA and osteoarthritis (OA)-THA.</p><p><strong>Patients and methods: </strong>Revision rates and reasons for revision were compared. Data collected in the Dutch Arthroplasty Register (LROI) between 2007 and 2018 was used. The study included 4,310 salvage-THAs, 12,159 fracture-THAs, and 274,147 OA-THAs. We performed Kaplan-Meier survival analyses and Cox regression to evaluate THA survival.</p><p><strong>Results: </strong>No statistically significant difference in revision rates between salvage-THAs and fracture-THAs was found (HR 1.0, 95% CI 0.7-1.3) whereas the revision rate was higher compared with OA-THAs (HR 1.3, CI 1.0-1.5). The 5-year revision rate was 5.0% (CI 4.4-5.8) in salvage-THAs, 4.5% (CI 4.1-5.0) in fracture-THAs, and 3.1% (CI 3.0-3.2) in OA-THAs. A higher revision rate for infection was found in salvage-THAs in comparison with fracture-THAs (HR 1.6, CI 1.0-2.3).</p><p><strong>Conclusion: </strong>We found no difference in revision rates for salvage-THAs compared with fracture-THAs. The risk of revision for infection was higher for salvage-THA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"399-403"},"PeriodicalIF":2.5000,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/f8/ActaO-94-17743.PMC10388365.pdf","citationCount":"1","resultStr":"{\"title\":\"Revision risk of salvage compared with acute total hip arthroplasty following femoral neck fracture: an analysis from the Dutch Arthroplasty Register.\",\"authors\":\"Peter P Schmitz, Gerjon Hannink, Matthijs P Somford, B Willem Schreurs, Job L C Van Susante\",\"doi\":\"10.2340/17453674.2023.17743\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>There is no consensus on the treatment of patients with femoral neck fractures between internal fixation (IF) or directly treated with a total hip arthroplasty (fracture-THA) in particular for the age group 60-70 years. Failure of IF is not uncommon, resulting in salvage total hip arthroplasty (salvage-THA). The aim of our study was to compare revision rates of salvage-THA with fracture-THA and osteoarthritis (OA)-THA.</p><p><strong>Patients and methods: </strong>Revision rates and reasons for revision were compared. Data collected in the Dutch Arthroplasty Register (LROI) between 2007 and 2018 was used. The study included 4,310 salvage-THAs, 12,159 fracture-THAs, and 274,147 OA-THAs. We performed Kaplan-Meier survival analyses and Cox regression to evaluate THA survival.</p><p><strong>Results: </strong>No statistically significant difference in revision rates between salvage-THAs and fracture-THAs was found (HR 1.0, 95% CI 0.7-1.3) whereas the revision rate was higher compared with OA-THAs (HR 1.3, CI 1.0-1.5). The 5-year revision rate was 5.0% (CI 4.4-5.8) in salvage-THAs, 4.5% (CI 4.1-5.0) in fracture-THAs, and 3.1% (CI 3.0-3.2) in OA-THAs. A higher revision rate for infection was found in salvage-THAs in comparison with fracture-THAs (HR 1.6, CI 1.0-2.3).</p><p><strong>Conclusion: </strong>We found no difference in revision rates for salvage-THAs compared with fracture-THAs. The risk of revision for infection was higher for salvage-THA.</p>\",\"PeriodicalId\":6916,\"journal\":{\"name\":\"Acta Orthopaedica\",\"volume\":\"94 \",\"pages\":\"399-403\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/f8/ActaO-94-17743.PMC10388365.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Orthopaedica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2340/17453674.2023.17743\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Orthopaedica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/17453674.2023.17743","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 1
摘要
背景和目的:对于股骨颈骨折患者是采用内固定(IF)还是直接行全髋关节置换术(骨折- tha)治疗尚无共识，特别是对于60-70岁年龄组的患者。IF失败并不罕见，导致补救性全髋关节置换术(salvage- tha)。本研究的目的是比较抢救式tha与骨折式tha和骨关节炎(OA)式tha的翻修率。患者和方法:比较翻修率和翻修原因。使用了2007年至2018年期间在荷兰关节成形术登记册(LROI)中收集的数据。该研究包括4,310个打捞式tha, 12,159个骨折式tha和274,147个oa - tha。我们采用Kaplan-Meier生存分析和Cox回归来评估THA的生存。结果:打捞式thas和骨折式thas的翻修率无统计学差异(HR 1.0, 95% CI 0.7-1.3)，而翻修率高于OA-THAs (HR 1.3, CI 1.0-1.5)。打捞式tha的5年修正率为5.0% (CI 4.4-5.8)，骨折式tha为4.5% (CI 4.1-5.0)， oa - tha为3.1% (CI 3.0-3.2)。与骨折式tha相比，打捞式tha的感染翻修率更高(HR 1.6, CI 1.0-2.3)。结论:我们发现打捞式tha翻修率与骨折式tha翻修率无差异。挽救式tha翻修感染的风险更高。
Revision risk of salvage compared with acute total hip arthroplasty following femoral neck fracture: an analysis from the Dutch Arthroplasty Register.
Background and purpose: There is no consensus on the treatment of patients with femoral neck fractures between internal fixation (IF) or directly treated with a total hip arthroplasty (fracture-THA) in particular for the age group 60-70 years. Failure of IF is not uncommon, resulting in salvage total hip arthroplasty (salvage-THA). The aim of our study was to compare revision rates of salvage-THA with fracture-THA and osteoarthritis (OA)-THA.
Patients and methods: Revision rates and reasons for revision were compared. Data collected in the Dutch Arthroplasty Register (LROI) between 2007 and 2018 was used. The study included 4,310 salvage-THAs, 12,159 fracture-THAs, and 274,147 OA-THAs. We performed Kaplan-Meier survival analyses and Cox regression to evaluate THA survival.
Results: No statistically significant difference in revision rates between salvage-THAs and fracture-THAs was found (HR 1.0, 95% CI 0.7-1.3) whereas the revision rate was higher compared with OA-THAs (HR 1.3, CI 1.0-1.5). The 5-year revision rate was 5.0% (CI 4.4-5.8) in salvage-THAs, 4.5% (CI 4.1-5.0) in fracture-THAs, and 3.1% (CI 3.0-3.2) in OA-THAs. A higher revision rate for infection was found in salvage-THAs in comparison with fracture-THAs (HR 1.6, CI 1.0-2.3).
Conclusion: We found no difference in revision rates for salvage-THAs compared with fracture-THAs. The risk of revision for infection was higher for salvage-THA.
期刊介绍：
Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
