Abstract：
BACKGROUND: Although excellent long-term results have been reported for the Exeter stem, stem fracture is recognized as a rare complication. However, there have been no reports on the incidence and risk factors for stem fractures based on detailed population information. This study aimed to clarify the incidence of Exeter hip stem fracture based on detailed population information from seven Exeter stem teaching centers in Japan and to examine the risk factors for stem fracture.
METHODS: A total of 8,499 primary total hip arthroplasties (THA) and 636 revision hip arthroplasties (revisions) performed at seven Exeter teaching hospitals between 1999 and 2021 were included and retrospectively investigated based on medical records.
RESULTS: Stem fractures were identified in two primary THA (fracture rate: 0.02%) and two revision THA (fracture rate: 0.21%) cases. The stem length was ≤125 mm in three out of these four cases. Revision and 30 stem were the risk factors for stem fractures. Weight and body mass index (BMI) were not significantly associated with the occurrence of stem fractures.
CONCLUSIONS: In Western countries, the incidence of Exeter stem fractures is reportedly 0.017-0.15% for primary THA and 0.99-1.21% for revision THA. In this study, the incidence of primary THA was 0.02%, which is similar to the lowest reported rate, whereas the incidence of revision THA was 0.21%, which is lower than that reported in previous studies. Revision surgery had the same risk factors as those reported in the West-namely, stem length ≤125 mm (except for the 30 stem) and BMI, which were not risk factors in Japanese patients.
METHODS: A total of 8,499 primary total hip arthroplasties (THA) and 636 revision hip arthroplasties (revisions) performed at seven Exeter teaching hospitals between 1999 and 2021 were included and retrospectively investigated based on medical records.
RESULTS: Stem fractures were identified in two primary THA (fracture rate: 0.02%) and two revision THA (fracture rate: 0.21%) cases. The stem length was ≤125 mm in three out of these four cases. Revision and 30 stem were the risk factors for stem fractures. Weight and body mass index (BMI) were not significantly associated with the occurrence of stem fractures.
CONCLUSIONS: In Western countries, the incidence of Exeter stem fractures is reportedly 0.017-0.15% for primary THA and 0.99-1.21% for revision THA. In this study, the incidence of primary THA was 0.02%, which is similar to the lowest reported rate, whereas the incidence of revision THA was 0.21%, which is lower than that reported in previous studies. Revision surgery had the same risk factors as those reported in the West-namely, stem length ≤125 mm (except for the 30 stem) and BMI, which were not risk factors in Japanese patients.
摘要：
背景：尽管已经报道了埃克塞特茎的出色长期结果，茎骨折被认为是一种罕见的并发症。然而,根据详细的人群信息,目前尚无关于干骨折发生率和危险因素的报告.本研究旨在根据日本七个Exeter干教学中心的详细人群信息，阐明Exeter髋干骨折的发生率，并研究干骨折的危险因素。
方法：纳入了1999年至2021年在7家埃克塞特教学医院进行的8,499例原发性全髋关节置换术（THA）和636例翻修髋关节置换术（修订版），并根据病历进行了回顾性调查。
结果：在2例原发性THA（骨折率：0.02％）和2例翻修THA（骨折率：0.21％）中发现了干骨折。在这四种情况中，有三种情况的茎长度≤125mm。修复性和30根是根茎骨折的危险因素。体重和体重指数（BMI）与干骨折的发生无明显相关性。
结论：在西方国家，据报道,原发性THA的Exeter干骨折发生率为0.017-0.15%,翻修THA的发生率为0.99-1.21%.在这项研究中,原发性THA的发生率为0.02%,这与报告的最低比率相似，而翻修THA的发生率为0.21%，低于以前的研究报告。翻修手术与西方报道的风险因素相同，即，茎长度≤125毫米（30茎除外）和BMI，这不是日本患者的危险因素。
方法：纳入了1999年至2021年在7家埃克塞特教学医院进行的8,499例原发性全髋关节置换术（THA）和636例翻修髋关节置换术（修订版），并根据病历进行了回顾性调查。
结果：在2例原发性THA（骨折率：0.02％）和2例翻修THA（骨折率：0.21％）中发现了干骨折。在这四种情况中，有三种情况的茎长度≤125mm。修复性和30根是根茎骨折的危险因素。体重和体重指数（BMI）与干骨折的发生无明显相关性。
结论：在西方国家，据报道,原发性THA的Exeter干骨折发生率为0.017-0.15%,翻修THA的发生率为0.99-1.21%.在这项研究中,原发性THA的发生率为0.02%,这与报告的最低比率相似，而翻修THA的发生率为0.21%，低于以前的研究报告。翻修手术与西方报道的风险因素相同，即，茎长度≤125毫米（30茎除外）和BMI，这不是日本患者的危险因素。
