Abstract：
BACKGROUND: Cementless fixation has become increasingly popular in hip arthroplasty due to its shorter operation time, easier technique, biologic fixation, and avoidance of bone cement implantation syndrome compared to cemented fixation. However, intraoperative periprosthetic femoral fracture (IOPFx) is a disconcerting complication during cementless hip arthroplasty. Our purpose was to identify the features of cementless stem that increase the risk of IOPFx during primary hip arthroplasty.
METHODS: We retrospectively reviewed all 4806 hip arthroplasties that was performed in a single institution from May 2003 to December 2020. Age at the index arthroplasty, sex, body mass index, physical status, ambulatory function, side of the operation, operational history, cause of the index arthroplasty, type of arthroplasty, surgical approach, surgeon, implant information, and events during the operation were investigated. The shoulder geometry and length of stem were also reviewed. The event of interest was narrowed down to IOPFx among various records of intraoperative events.
RESULTS: We found IOPFx of 2.6% among all the hips operated with cementless stem. In the multivariable analysis, female (OR = 1.52), childhood hip disease (OR = 2.30), stove-pipe femur (OR = 2.43), combined approach (OR = 2.60), and standard length of stem (OR = 1.59) were found to be significant risk factors of IOPFx.
CONCLUSIONS: In conclusion, a stem with a standard length is significantly associated with risk of IOPFx compared to a shortened stem. These findings highlight the importance of careful consideration in terms of the risk of IOPFx when standard length cementless stem is chosen.
METHODS: We retrospectively reviewed all 4806 hip arthroplasties that was performed in a single institution from May 2003 to December 2020. Age at the index arthroplasty, sex, body mass index, physical status, ambulatory function, side of the operation, operational history, cause of the index arthroplasty, type of arthroplasty, surgical approach, surgeon, implant information, and events during the operation were investigated. The shoulder geometry and length of stem were also reviewed. The event of interest was narrowed down to IOPFx among various records of intraoperative events.
RESULTS: We found IOPFx of 2.6% among all the hips operated with cementless stem. In the multivariable analysis, female (OR = 1.52), childhood hip disease (OR = 2.30), stove-pipe femur (OR = 2.43), combined approach (OR = 2.60), and standard length of stem (OR = 1.59) were found to be significant risk factors of IOPFx.
CONCLUSIONS: In conclusion, a stem with a standard length is significantly associated with risk of IOPFx compared to a shortened stem. These findings highlight the importance of careful consideration in terms of the risk of IOPFx when standard length cementless stem is chosen.
摘要：
背景：无水泥固定由于其手术时间较短，在髋关节置换术中越来越受欢迎，更简单的技术，生物固定，与骨水泥固定相比，避免骨水泥植入综合征。然而,术中股骨假体周围骨折(IOPFx)是非骨水泥髋关节置换术中一个令人不安的并发症.我们的目的是确定在初次髋关节置换术中增加IOPFx风险的非骨水泥茎的特征。
方法：我们回顾性回顾了2003年5月至2020年12月在单个机构中进行的所有4806例髋关节置换术。索引关节成形术的年龄，性别,身体质量指数,身体状况,步行功能,行动的一面，运营历史,索引关节成形术的原因，关节成形术的类型，手术方法,外科医生,植入信息,并对手术过程中的事件进行了调查。还回顾了肩的几何形状和茎的长度。在各种术中事件记录中，感兴趣的事件缩小到IOPFx。
结果：我们发现，在所有使用无骨水泥茎手术的臀部中，IOPFx为2.6％。在多变量分析中，女性（OR=1.52），儿童髋关节疾病（OR=2.30），火炉管股骨（OR=2.43），组合方法(OR=2.60)，和标准茎长度（OR=1.59）是IOPFx的重要危险因素。
结论：结论：与缩短的茎相比，具有标准长度的茎与IOPFx的风险显着相关。这些发现强调了在选择标准长度无水泥茎时仔细考虑IOPFx风险的重要性。
方法：我们回顾性回顾了2003年5月至2020年12月在单个机构中进行的所有4806例髋关节置换术。索引关节成形术的年龄，性别,身体质量指数,身体状况,步行功能,行动的一面，运营历史,索引关节成形术的原因，关节成形术的类型，手术方法,外科医生,植入信息,并对手术过程中的事件进行了调查。还回顾了肩的几何形状和茎的长度。在各种术中事件记录中，感兴趣的事件缩小到IOPFx。
结果：我们发现，在所有使用无骨水泥茎手术的臀部中，IOPFx为2.6％。在多变量分析中，女性（OR=1.52），儿童髋关节疾病（OR=2.30），火炉管股骨（OR=2.43），组合方法(OR=2.60)，和标准茎长度（OR=1.59）是IOPFx的重要危险因素。
结论：结论：与缩短的茎相比，具有标准长度的茎与IOPFx的风险显着相关。这些发现强调了在选择标准长度无水泥茎时仔细考虑IOPFx风险的重要性。
