目的:本研究的目的是描述股骨假体周围骨折(PPF)患者的人口学细节,PPF的流行病学,PPF特性,以及英国人口中PPF类型的预测因子。
方法:这是一项多中心回顾性队列研究,包括2018年1月1日至2018年12月31日期间到医院接受新PPF治疗的成年患者。收集的数据包括:患者特征,合并症,抗凝剂的使用,社会环境,流动性水平,断裂特征,统一分类系统(UCS)类型,以及原始植入物的细节。按骨折位置进行描述性分析,使用混合效应逻辑回归模型评估PPF类型的预测因子。
结果:总计,包括来自27个NHS位点的720个股骨PPF。PPF患者通常是老年人(平均79.9岁(SD10.6)),女性(n=455;63.2%),至少有一种合并症(n=670;93.1%),并且在入院前依赖助行器或卧床/椅子(n=419;61.7%)。研究人群包括539(74.9%)髋部PPFs,151(21.0%)膝关节PPFs,和30个(4.2%)划分型PPF。对于髋关节(n=407;75.5%)和膝关节(n=88;58.3%),关节成形术UCSB型骨折最常见。总的来说,556(86.2%)在医院接受治疗,89(13.8%)需要转移治疗。女性是股髋PPFs骨折类型(A/B1/C型与B2/B3型)的唯一重要预测因素(比值比0.61(95%置信区间0.41至0.91);p=0.014)。性,住宅类型,原发性与翻修植入物PPF,植入物固定,关节成形术和PPF之间的时间不能预测髋部PPF的骨折类型。
结论:此多中心分析描述了在英国各地中心出现股骨PPF患者的患者和损伤因素。这些病人一般都是年老体弱,相当于那些髋部骨折的人。这些数据可用于规划未来的服务和临床试验。引用本文:骨关节J2022;104-B(8):987-996。
OBJECTIVE: The aim of this
study was to describe the demographic details of patients who sustain a
femoral periprosthetic fracture (PPF), the epidemiology of PPFs, PPF characteristics, and the predictors of PPF types in the UK population.
METHODS: This is a multicentre retrospective cohort
study including adult patients presenting to hospital with a new PPF between 1 January 2018 and 31 December 2018. Data collected included: patient characteristics, comorbidities, anticoagulant use, social circumstances, level of mobility, fracture characteristics, Unified Classification System (UCS) type, and details of the original implant. Descriptive analysis by fracture location was performed, and predictors of PPF type were assessed using mixed-effects logistic regression models.
RESULTS: In total, 720
femoral PPFs from 27 NHS sites were included. PPF patients were typically elderly (mean 79.9 years (SD 10.6)), female (n = 455; 63.2%), had at least one comorbidity (n = 670; 93.1%), and were reliant on walking aids or bed-/chair-bound prior to admission (n = 419; 61.7%). The
study population included 539 (74.9%) hip PPFs, 151 (21.0%) knee PPFs, and 30 (4.2%) dividing type PPFs. For hip (n = 407; 75.5%) and knee (n = 88; 58.3%) arthroplasty UCS B type fractures were most common. Overall, 556 (86.2%) were treated in the presenting hospital and 89 (13.8%) required transfer for treatment. Female sex was the only significant predictor of fracture type (A/B1/C type versus B2/B3) for femoral hip PPFs (odds ratio 0.61 (95% confidence interval 0.41 to 0.91); p = 0.014). Sex, residence type, primary versus revision implant PPF, implant fixation, and time between arthroplasty and PPF were not found to predict fracture type for hip PPFs.
CONCLUSIONS: This multicentre analysis describes patient and injury factors for patients presenting with femoral PPFs to centres across the UK. These patients are generally elderly and frail, comparable to those sustaining a hip fracture. These data can be useful in planning future services and clinical trials. Cite this article: Bone Joint J 2022;104-B(8):987-996 .