股骨颈骨折的关节置换术存在股骨外侧偏移恢复不足的风险。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-01-01 Epub Date: 2023-04-26 DOI:10.1177/11207000231169914
Harsh N Shah, Andrew A Barrett, Andrea K Finlay, Prerna Arora, Michael J Bellino, Julius A Bishop, Michael J Gardner, Matthew D Miller, James I Huddleston, William J Maloney, Stuart B Goodman, Derek F Amanatullah
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引用次数: 0

摘要

目的:该研究旨在通过比较非关节置换外科医生(NAS)和选择性关节置换外科医生(EAS),确定外侧偏移、腿长和髋臼组件位置对髋关节生物力学的恢复情况。方法:回顾性研究了131例股骨颈骨折患者,其中7例由EAS治疗,20例由NAS治疗。两名盲人观察员测量了腿长差异、股骨偏移和髋臼组件位置。多变量逻辑回归模型检验了外科医生组与股骨外侧、髋臼偏移、腿长差异、髋臼内翻、髋臼位置和组件大小恢复之间的关系,同时调整了手术方法和脊柱病理学:与未受伤的一侧(48.7 ± 7.1 mm,p = 0.044)相比,NAS在THA术后股骨外侧偏移恢复不足4.8 mm(43.9 ± 8.7 mm)。与EAS相比,NAS有股骨外侧偏移恢复不足的风险(p = 0.040)。髋臼外侧偏移、腿长、髋臼位置或组件大小与外科医生类型之间没有关联:结论:股骨外侧偏移在股骨颈骨折的THA术后有复位不足的风险,如果由不经常进行选择性THA的外科医生实施,则会出现这种风险。这表明,在为股骨颈骨折患者实施 THA 手术时,股骨外侧偏移是导致髋关节不稳定的一个未被充分重视的因素。股骨外侧偏移与髋臼组件位置一样值得关注和认识,因为对我们的数据进行的二次分析表明,术前模板和术中成像并不能防止复位不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Arthroplasty for femoral neck fractures is at risk for under restoration of lateral femoral offset.

Purpose: The aim of the study was to determine the restoration of hip biomechanics through lateral offset, leg length, and acetabular component position when comparing non-arthroplasty surgeons (NAS) to elective arthroplasty surgeons (EAS).

Methods: 131 patients, with a femoral neck fracture treated with a THA by 7 EAS and 20 NAS, were retrospectively reviewed. 2 blinded observers measured leg-length discrepancy, femoral offset, and acetabular component position. Multivariate logistic regression models examined the association between the surgeon groups and restoration of lateral femoral, acetabular offset, leg length discrepancy, acetabular anteversion, acetabular position, and component size, while adjusting for surgical approach and spinal pathology.

Results: NAS under-restored 4.8 mm of lateral femoral offset (43.9 ± 8.7 mm) after THA when compared to the uninjured side (48.7 ± 7.1 mm, p= 0.044). NAS were at risk for under-restoring lateral femoral offset when compared to EAS (p= 0.040). There was no association between lateral acetabular offset, leg length, acetabular position, or component size and surgeon type.

Conclusions: Lateral femoral offset is at risk for under-restoration after THA for femoral neck fractures, when performed by surgeons that do not regularly perform elective THA. This indicates that lateral femoral offset is an under-appreciated contributor to hip instability when performing THA for a femoral neck fracture. Lateral femoral offset deserves as much attention and awareness as acetabular component position since a secondary analysis of our data reveal that preoperative templating and intraoperative imaging did not prevent under-restoration.

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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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