PDF(Pubmed)
Abstract：
UNASSIGNED: Periprosthetic fracture is a rare complication of arthroplasty but can have devastating consequences for the patient and presents a complex surgical challenge. Locking compression plate and retrograde intramedullary nail are both widely accepted surgical fixation techniques for distal femoral periprosthetic fractures around a total knee arthroplasty. Although there is still a need for further high-quality research into both techniques, there is even less literature concerning the use of distal femoral replacement to treat distal femoral periprosthetic fractures. Interest has been piqued in distal femoral replacements for the treatment of distal femoral periprosthetic fractures due to the theoretical advantages of immediate post-operative weight-bearing and lack of dependence on fracture union, but there are still understandably reservations about performing such an extensive and invasive procedure when an accepted alternative is available. This meta-analysis aims to evaluate the current literature to compare the complication rates and return to pre-operative ambulatory status of distal femoral replacement and locking compression plate.
UNASSIGNED: A literature search was performed to identify articles related to the management of distal femoral periprosthetic fractures around a total knee arthroplasty in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Methodological quality was assessed using the methodological index for non-randomized studies (MINORS) criteria. Articles were reviewed, and data extracted for analysis.
UNASSIGNED: Five articles met the inclusion criteria, reporting on 345 periprosthetic fractures. The overall rates of complications for distal femoral replacement and locking compression plate were: re-operation (6.1% vs 12.1%), infection (3.0% vs 5.3%), mortality (19.7% vs 19.3%), and return to pre-operative ambulatory status (60.9% vs 71.8%) (respectively).
UNASSIGNED: This meta-analysis shows no statistically significant difference in the rates of re-operation, infection, mortality or return to pre-operative ambulatory status when comparing distal femoral replacement to locking compression plate.
UNASSIGNED: A literature search was performed to identify articles related to the management of distal femoral periprosthetic fractures around a total knee arthroplasty in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Methodological quality was assessed using the methodological index for non-randomized studies (MINORS) criteria. Articles were reviewed, and data extracted for analysis.
UNASSIGNED: Five articles met the inclusion criteria, reporting on 345 periprosthetic fractures. The overall rates of complications for distal femoral replacement and locking compression plate were: re-operation (6.1% vs 12.1%), infection (3.0% vs 5.3%), mortality (19.7% vs 19.3%), and return to pre-operative ambulatory status (60.9% vs 71.8%) (respectively).
UNASSIGNED: This meta-analysis shows no statistically significant difference in the rates of re-operation, infection, mortality or return to pre-operative ambulatory status when comparing distal femoral replacement to locking compression plate.
摘要：
■假体周围骨折是关节成形术的罕见并发症，但可能对患者造成破坏性后果，并提出了复杂的手术挑战。锁定加压钢板和逆行髓内钉都是全膝关节置换术周围股骨远端假体周围骨折的广泛接受的手术固定技术。尽管仍需要对这两种技术进行进一步的高质量研究，关于使用股骨远端置换治疗股骨远端假体周围骨折的文献甚至更少。由于术后立即负重和不依赖骨折愈合的理论优势，在股骨远端置换治疗股骨远端假体周围骨折引起了人们的兴趣，但是，在有可接受的替代方案时，对于执行如此广泛和侵入性的程序仍然存在可以理解的保留。这项荟萃分析旨在评估现有文献，以比较股骨远端置换和锁定加压钢板的并发症发生率和恢复到术前的动态状态。
■进行了文献检索，以根据系统评价和荟萃分析（PRISMA）清单的首选报告项目确定与全膝关节置换术前后股骨远端假体周围骨折处理相关的文章。使用非随机研究方法学指数（MINORS）标准评估方法学质量。文章被审查，并提取数据进行分析。
■五篇文章符合入选标准，报告345例假体周围骨折。股骨远端置换和锁定加压钢板的总并发症发生率为：再次手术（6.1%vs12.1%），感染（3.0%vs5.3%），死亡率（19.7%vs19.3%），并恢复到术前卧床状态（分别为60.9%和71.8%）。
■这项荟萃分析显示，再手术率没有统计学上的显着差异，感染,将股骨远端置换与锁定加压钢板进行比较时，死亡率或恢复到术前动态状态。
■进行了文献检索，以根据系统评价和荟萃分析（PRISMA）清单的首选报告项目确定与全膝关节置换术前后股骨远端假体周围骨折处理相关的文章。使用非随机研究方法学指数（MINORS）标准评估方法学质量。文章被审查，并提取数据进行分析。
■五篇文章符合入选标准，报告345例假体周围骨折。股骨远端置换和锁定加压钢板的总并发症发生率为：再次手术（6.1%vs12.1%），感染（3.0%vs5.3%），死亡率（19.7%vs19.3%），并恢复到术前卧床状态（分别为60.9%和71.8%）。
■这项荟萃分析显示，再手术率没有统计学上的显着差异，感染,将股骨远端置换与锁定加压钢板进行比较时，死亡率或恢复到术前动态状态。
