Revision rate following unipolar versus bipolar hemiarthroplasty.

IF 1.3 4区 医学 Q3 ORTHOPEDICS HIP International Pub Date : 2024-07-01 Epub Date: 2024-03-14 DOI:10.1177/11207000241235394
David Kugelman, Joseph X Robin, Benjamin C Schaffler, Roy Davidovitch, Kenneth Egol, Ran Schwarzkopf
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Abstract

Introduction: There has been much debate on use of bipolar or unipolar femoral heads in hemiarthroplasty for the treatment of femoral neck fractures. The outcome of these implants should be studied in the America Joint Replacement Registry (AJRR).

Methods: All primary femoral neck fractures treated with hemiarthroplasty between January 2012 and June 2020 were searched in the AJRR. All cause-revision of unipolar and bipolar hemiarthroplasty and reasons for revision were assessed for these patients until June of 2023.

Results: There were no differences in number and reason for all cause revisions between unipolar and bipolar hemiarthroplasty (p= 0.41). Bipolar hemiarthroplasty had more revisons at 6 months postoperatively (p= 0.0281), but unipolar hemiarthroplasty had more revisions between 2 and 3 years (p= 0.0003), and after 3-years (p= 0.0085), as analysed with a Cox model. Patients with older age (HR = 0.999; 95% CI, 0.998-0.999; p= 0.0006) and higher Charlson Comorbidity Index (HR = 0.996; 95% CI, 0.992- 0.999; p= 0.0192) had a significant increase in revision risk.

Conclusions: We suggest that surgeons should consider using bipolar prosthesis when performing hemiarthroplasty for femoral neck fracture in patients expected to live >2 years post injury.

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单极与双极半关节成形术后的翻修率。
导言:关于在半关节成形术中使用双极或单极股骨头治疗股骨颈骨折的问题一直争论不休。美国关节置换登记处(AJRR)应对这些植入物的效果进行研究:方法:在美国关节置换登记处检索了2012年1月至2020年6月期间所有采用半关节置换术治疗的原发性股骨颈骨折。结果:截至 2023 年 6 月,对这些患者的单极和双极半关节成形术的所有翻修原因和翻修原因进行了评估:结果:单极和双极半关节成形术的所有原因翻修次数和原因均无差异(P = 0.41)。根据Cox模型分析,双极半关节成形术术后6个月的翻修率更高(p = 0.0281),但单极半关节成形术术后2至3年的翻修率更高(p = 0.0003),3年后的翻修率更高(p = 0.0085)。年龄较大(HR = 0.999; 95% CI, 0.998-0.999; p = 0.0006)和Charlson合并症指数较高(HR = 0.996; 95% CI, 0.992- 0.999; p = 0.0192)的患者翻修风险显著增加:我们建议外科医生在为预计伤后存活时间超过2年的股骨颈骨折患者实施半关节置换术时,应考虑使用双极假体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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