UNASSIGNED: This retrospective study was conducted using the PearlDiver database (www.pearldiverinc.com, Colorado Springs) and identified all patients undergoing THA between 2010 and 2019. Among this group, we included all patients who had received one of the three procedures , hip hemiarthroplasty (CPT 27125), fixation of the intertrochanteric fracture with plates and screws (CPT 27444), or fixation of hip fracture with nail (CPT 27445) within two years of THA. We analyzed complications in these patients and compared it to the complication rate in primary THA patients. The complications analyzed were 30-day transfusion risk, 90-day surgical site infection (SSI) risk, 90-day periprosthetic fracture risk, 1-year dislocation risk, and 2-, 5-, and 10-year revision risk.
UNASSIGNED: A total of 118,209 patients underwent THA between 2010 and 2019. A total of 9,173, 48,326, and 31,632 patients underwent fixation with plates and screws , nailing and hemiarthroplasty respectively. We identified 71, 42, and 160 patients with hemiarthroplasty, plates & screws, and nailing, respectively, within two years of THA. 117,936 primary THA patients were used as a comparison group. The nailing group had the highest rate of transfusion risk (OR=2.34, 95% CI=1.32, 4.13, P<0.05).Furthermore, the hemiarthroplasty group had highest rate of SSI risk (OR=9.25, 95% CI=4.86, 17.63, P<0.05) and highest revision risk at 2 years (OR=10.532, 95% CI= 6.09, 18.19, P<0.05).
UNASSIGNED: Conversion of hemiarthroplasty to THA was associated with a higher risk of infection and revision. Hence, surgeons considering primary hip hemiarthroplasty for severely comminuted intertrochanteric fracture should exercise caution, especially for active elderly patients.
UNASSIGNED:这项回顾性研究是使用PearlDiver数据库进行的(www.pearldiverinc.com,科罗拉多斯普林斯),并确定了2010年至2019年期间接受THA的所有患者。在这个群体中,我们包括了所有接受过三种手术之一的患者,髋关节置换术(CPT27125),用钢板和螺钉固定股骨转子间骨折(CPT27444),或在THA的两年内用钉(CPT27445)固定髋部骨折。我们分析了这些患者的并发症,并将其与原发性THA患者的并发症发生率进行了比较。并发症分析为30天输血风险,90天手术部位感染(SSI)风险,90天假体周围骨折风险,1年错位风险,and2-,5-,和10年修订风险。
未经评估:在2010年至2019年期间,共有118,209例患者接受了THA。共有9,173,48,326,31,632名患者接受了钢板和螺钉的固定,分别为钉和半髋关节置换术。我们确定了71、42和160例人工股骨头置换术患者,板和螺钉,和钉子,分别,在THA的两年内。117936例原发性THA患者作为对比组。钉组输血风险发生率最高(OR=2.34,95%CI=1.32,4.13,P<0.05)。此外,半髋关节置换组的SSI风险最高(OR=9.25,95%CI=4.86,17.63,P<0.05),2年修正风险最高(OR=10.532,95%CI=6.09,18.19,P<0.05)。
UNASSIGNED:半髋关节置换术转换为THA与更高的感染和翻修风险相关。因此,考虑对严重粉碎性股骨转子间骨折进行初次髋关节置换术的外科医生应谨慎行事,特别是活跃的老年患者。