Nicholas B. Pohl MS , Arjun Saxena MD, MBA , Jeffrey B. Stambough MD , John Ryan Martin MD , Simon C. Mears MD, PhD
{"title":"谁在治疗股骨假体周围骨折？假体周围研究联盟分析","authors":"Nicholas B. Pohl MS , Arjun Saxena MD, MBA , Jeffrey B. Stambough MD , John Ryan Martin MD , Simon C. Mears MD, PhD","doi":"10.1016/j.artd.2024.101428","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based on surgical training or patient factors.</p></div><div><h3>Methods</h3><p>This multicenter retrospective study evaluated patients surgically treated for Vancouver B PPFF after THA between 2014 and 2019. Patients from 11 academic centers located in the United States were included in this study. Surgical outcomes and patient demographics were evaluated based on surgeon training, surgical treatment type, and institution.</p></div><div><h3>Results</h3><p>Presence of Vancouver B2 (odds ratio [OR]: 0.02, <em>P</em> < .001) or B3 (OR: 0.04, <em>P</em> < .001) fractures were independent risk factors for treatment with rTHA. Treatment by a trauma (OR: 12.49, <em>P</em> < .001) or other-specified surgeon (OR: 13.63, <em>P</em> < .001) were independent risk factors for ORIF repair of Vancouver B fractures. There were no differences in outcomes based on surgeon subspecialty training.</p></div><div><h3>Conclusions</h3><p>This study showed the trends in surgeons who surgically manage Vancouver B fractures at 11 major academic institutions and highlighted that regardless of surgical training or surgical treatment type, postoperative outcomes following management of PPFF were similar.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101428"},"PeriodicalIF":1.5000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001134/pdfft?md5=b5f1f56dd70b9c8bed7ee7897542a924&pid=1-s2.0-S2352344124001134-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Who Is Treating Periprosthetic Femur Fractures? An Analysis of the Periprosthetic Research Consortium\",\"authors\":\"Nicholas B. Pohl MS , Arjun Saxena MD, MBA , Jeffrey B. Stambough MD , John Ryan Martin MD , Simon C. Mears MD, PhD\",\"doi\":\"10.1016/j.artd.2024.101428\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based on surgical training or patient factors.</p></div><div><h3>Methods</h3><p>This multicenter retrospective study evaluated patients surgically treated for Vancouver B PPFF after THA between 2014 and 2019. Patients from 11 academic centers located in the United States were included in this study. Surgical outcomes and patient demographics were evaluated based on surgeon training, surgical treatment type, and institution.</p></div><div><h3>Results</h3><p>Presence of Vancouver B2 (odds ratio [OR]: 0.02, <em>P</em> < .001) or B3 (OR: 0.04, <em>P</em> < .001) fractures were independent risk factors for treatment with rTHA. Treatment by a trauma (OR: 12.49, <em>P</em> < .001) or other-specified surgeon (OR: 13.63, <em>P</em> < .001) were independent risk factors for ORIF repair of Vancouver B fractures. There were no differences in outcomes based on surgeon subspecialty training.</p></div><div><h3>Conclusions</h3><p>This study showed the trends in surgeons who surgically manage Vancouver B fractures at 11 major academic institutions and highlighted that regardless of surgical training or surgical treatment type, postoperative outcomes following management of PPFF were similar.</p></div>\",\"PeriodicalId\":37940,\"journal\":{\"name\":\"Arthroplasty Today\",\"volume\":\"29 \",\"pages\":\"Article 101428\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2352344124001134/pdfft?md5=b5f1f56dd70b9c8bed7ee7897542a924&pid=1-s2.0-S2352344124001134-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroplasty Today\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352344124001134\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124001134","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Who Is Treating Periprosthetic Femur Fractures? An Analysis of the Periprosthetic Research Consortium
Background
Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based on surgical training or patient factors.
Methods
This multicenter retrospective study evaluated patients surgically treated for Vancouver B PPFF after THA between 2014 and 2019. Patients from 11 academic centers located in the United States were included in this study. Surgical outcomes and patient demographics were evaluated based on surgeon training, surgical treatment type, and institution.
Results
Presence of Vancouver B2 (odds ratio [OR]: 0.02, P < .001) or B3 (OR: 0.04, P < .001) fractures were independent risk factors for treatment with rTHA. Treatment by a trauma (OR: 12.49, P < .001) or other-specified surgeon (OR: 13.63, P < .001) were independent risk factors for ORIF repair of Vancouver B fractures. There were no differences in outcomes based on surgeon subspecialty training.
Conclusions
This study showed the trends in surgeons who surgically manage Vancouver B fractures at 11 major academic institutions and highlighted that regardless of surgical training or surgical treatment type, postoperative outcomes following management of PPFF were similar.
期刊介绍：
Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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