PDF(Pubmed)
Abstract：
UNASSIGNED: The number of total knee replacements (TKRs) performed per year has been increasing annually and it is estimated that by 2030 demand would reach 3.48 million procedures per year in the United States Of America. The prevalence of periprosthetic fractures (PPFs) around TKRs has followed this trend with incidences ranging from 0.3% to 3.5%. Distal femoral PPFs are associated with significant morbidity and mortality. When there is sufficient bone stock in the distal femur and a fracture pattern conducive to fixation, locking compression plating (LCP) and retrograde intramedullary nailing (RIMN) are commonly used fixation strategies. Conversely, in situations with loosening and deficient bone stock, a salvage procedure such as a distal femoral replacement is recognized as an alternative. This meta-analysis investigates the rates of non-union, re-operation, infection, and mortality for LCPs and RIMNs when performed for distal femoral PPFs fractures around TKRs.
UNASSIGNED: A search was conducted to identify articles relevant to the management of distal femoral PPFs around TKRs in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Articles meeting the inclusion criteria were then assessed for methodological quality using the methodological items for non-randomised studies (MINORS) criteria. Articles were reviewed, and data were compiled into tables for analysis.
UNASSIGNED: 10 articles met the inclusion criteria, reporting on 528 PPFs. The overall incidence of complications was: non-union 9.4%, re-operation 12.9%, infection 2.4%, and mortality 5.5%. This meta-analysis found no significant differences between RIMN and LCP in rates of non-union (9.2% vs 9.6%) re-operation (15.1% vs 11.3%), infection (2.1% vs 2.6%), and mortality (6.0% vs 5.2%), respectively.
UNASSIGNED: This meta-analysis demonstrated no significant difference in rates of non-union, re-operation, infection, and mortality between RIMN and LCP and both remain valid surgical treatment options.
UNASSIGNED: A search was conducted to identify articles relevant to the management of distal femoral PPFs around TKRs in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Articles meeting the inclusion criteria were then assessed for methodological quality using the methodological items for non-randomised studies (MINORS) criteria. Articles were reviewed, and data were compiled into tables for analysis.
UNASSIGNED: 10 articles met the inclusion criteria, reporting on 528 PPFs. The overall incidence of complications was: non-union 9.4%, re-operation 12.9%, infection 2.4%, and mortality 5.5%. This meta-analysis found no significant differences between RIMN and LCP in rates of non-union (9.2% vs 9.6%) re-operation (15.1% vs 11.3%), infection (2.1% vs 2.6%), and mortality (6.0% vs 5.2%), respectively.
UNASSIGNED: This meta-analysis demonstrated no significant difference in rates of non-union, re-operation, infection, and mortality between RIMN and LCP and both remain valid surgical treatment options.
摘要：
每年进行的膝关节置换手术（TKR）的数量逐年增加，据估计，到2030年，美国每年的需求将达到348万例。TKRs周围假体周围骨折（PPF）的患病率遵循这一趋势，发生率为0.3％至3.5％。股骨远端PPFs与显著的发病率和死亡率相关。当股骨远端有足够的骨量和有利于固定的骨折模式时，锁定加压钢板（LCP）和逆行髓内钉（RIMN）是常用的固定策略。相反，在松动和骨骼储备不足的情况下，诸如股骨远端置换之类的抢救程序被认为是一种替代方法。这项荟萃分析调查了不愈合的比率，重新操作,感染,对于TKRs周围的股骨远端PPFs骨折，LCP和RIMNs的死亡率。
■在遵循系统评价和荟萃分析(PRISMA)检查表的首选报告项目的情况下，对与TKRs周围股骨远端PPFs管理相关的文章进行了搜索。然后使用非随机研究（MINORS）标准的方法学项目评估符合纳入标准的文章的方法学质量。文章被审查，并将数据汇编成表进行分析。
■10篇文章符合入选标准，报告528个PPF。并发症的总发生率为：不愈合9.4%，再操作12.9%，感染2.4%，死亡率为5.5%。这项荟萃分析发现，RIMN和LCP在不愈合率(9.2%vs9.6%)再次手术(15.1%vs11.3%)方面没有显著差异，感染(2.1%vs2.6%)，和死亡率(6.0%对5.2%)，分别。
■这项荟萃分析表明，不愈合率没有显着差异，重新操作,感染,RIMN和LCP之间的死亡率和两者仍然是有效的手术治疗选择。
■在遵循系统评价和荟萃分析(PRISMA)检查表的首选报告项目的情况下，对与TKRs周围股骨远端PPFs管理相关的文章进行了搜索。然后使用非随机研究（MINORS）标准的方法学项目评估符合纳入标准的文章的方法学质量。文章被审查，并将数据汇编成表进行分析。
■10篇文章符合入选标准，报告528个PPF。并发症的总发生率为：不愈合9.4%，再操作12.9%，感染2.4%，死亡率为5.5%。这项荟萃分析发现，RIMN和LCP在不愈合率(9.2%vs9.6%)再次手术(15.1%vs11.3%)方面没有显著差异，感染(2.1%vs2.6%)，和死亡率(6.0%对5.2%)，分别。
■这项荟萃分析表明，不愈合率没有显着差异，重新操作,感染,RIMN和LCP之间的死亡率和两者仍然是有效的手术治疗选择。
