骨质疏松会增加TKA术后股骨远端假体周围骨折的风险,尤其是有骨质疏松性骨折史的患者。因此,原发性TKA后患者需要认真评估和正确治疗骨质疏松的需求,以及服用骨质疏松药物的重要性。
目的:骨质疏松是骨折的危险因素,包括臀部的,椎骨,和桡骨远端;然而,骨质疏松与全膝关节置换术(TKA)后假体周围骨折之间的相关性研究不多.因此,我们旨在探讨TKA术后假体周围骨折与全身性骨质疏松的关系.
方法:本研究纳入了34例原发性TKA术后假体周围骨折患者和106例年龄和性别相匹配的对照。在股骨颈评估骨矿物质密度,全髋关节,和腰椎使用双X射线吸收法。对医疗记录进行年龄审查;性别;体重指数;吸烟;类风湿性关节炎,内分泌疾病,心血管疾病;糖皮质激素使用史;骨质疏松药物治疗;既往骨质疏松性骨折史。此外,评估TKA后的股骨前切口。单变量和多变量logistic回归分析用于确定与假体周围骨折相关的因素。
结果:骨折组骨质疏松患病率高于对照组(61.8%vs.40.6%,p=0.045)。骨折组骨质疏松的用药率显着低(47.6%vs76.7%,p=0.026)。既往骨质疏松性骨折史(比值比[OR],9.1;p=0.015)和骨质疏松症(OR,3.6;p=0.013)是TKA后假体周围骨折的重要危险因素。骨质疏松症的药物治疗可降低假体周围骨折的风险(OR0.3;p=0.020)。
结论:骨质疏松是TKA术后股骨远端假体周围骨折的主要危险因素。因此,对原发性TKA后的患者,需要认真评估和正确治疗骨质疏松的需求以及服用骨质疏松药物的重要性,尤其是有骨质疏松性骨折史的患者。
方法:预后研究,三级。
Osteoporosis increases the risk of periprosthetic distal femoral fractures after TKA, especially in patients with a history of osteoporotic fractures. Therefore, careful assessment and proper treatment of osteoporosis need and the importance of taking osteoporotic medication needs to be recognized by the patients following primary TKA.
OBJECTIVE: Osteoporosis is a risk factor for fractures, including those of the hip, vertebrae, and distal radius; however, the association between osteoporosis and periprosthetic fractures after total knee arthroplasty (TKA) has not been much investigated. Therefore, we aimed to investigate the association of the presence of systemic osteoporosis with periprosthetic fractures after TKA.
METHODS: This study included 34 patients with periprosthetic fractures following primary TKA and 106 controls matched for age and sex. Bone mineral density was evaluated at the femoral neck, total hip, and lumbar spine using dual X-ray absorptiometry. Medical records were reviewed for age; sex; body mass index; smoking; rheumatoid arthritis, endocrine diseases, and cardiovascular diseases; history of glucocorticoid use; medication for osteoporosis; and history of previous osteoporotic fracture. In addition, anterior femoral notching after TKA was evaluated. Univariable and multivariable logistic regression analysis were used to determine factors associated with periprosthetic fracture.
RESULTS: The prevalence of osteoporosis in the fracture group was higher than that in the control group (61.8% vs. 40.6%, p=0.045). The rate of medication for osteoporosis was significantly low in the fracture group (47.6 % vs 76.7%, p=0.026). History of previous osteoporotic fracture (odds ratio [OR], 9.1; p=0.015) and osteoporosis (OR, 3.6; p=0.013) were significant risk factors for periprosthetic fractures after TKA. Medication for osteoporosis could decrease the risk of periprosthetic fracture (OR 0.3; p=0.020).
CONCLUSIONS: Osteoporosis is a major risk factor for periprosthetic distal femoral fractures after TKA. Therefore, careful assessment and proper treatment of osteoporosis need and the importance of taking osteoporotic medication needs to be recognized to the patients following primary TKA, especially in patients with a history of osteoporotic fracture.
METHODS: Prognostic study, level III.