Retrospective survival analysis of the use of uncemented modular tapered stems for revision in periprosthetic Vancouver B-type fractures. Is instability a threat to survival?

Q3 Medicine Revista Espanola de Cirugia Ortopedica y Traumatologia Pub Date : 2025-01-01 Epub Date: 2024-03-22 DOI:10.1016/j.recot.2024.03.010
J Lixa, P Vieira, P Pereira, A Pinho, M Seara, A Sousa, L Vieira
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Abstract

Introduction and objectives: Periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival.

Materials and methods: We performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan). Demographic and radiographic parameters were analyzed. The survival rate (free of reoperation) was calculated at 2- and 5-years using the Kaplan-Meier survivorship analysis.

Results: Thirty-nine patients were included with a mean age of 73.5 years and a mean follow-up of 5 years. Arthroplasty survivorship at 2 years was 73.7% and at 5 years was 67.5% (mean 8.4 years; range 6.7-10.2). Survivorship was inferior in the patients with episodes of instability (mean 2.5 years; range 0-5.42) (p<0.001). At least one episode of instability occurred in 26.3% of patients and 60% of these patients had a femoral head size 32mm or lower. At least one episode of instability occurred in 71.4% of patients with a greater trochanter fracture (p=0.008). The consolidation rate was 90.6% and the mortality rate was 23.7%. In the group of patients that died, 55.6% were submitted to at least one revision surgery (p=0.044).

Conclusion: Survivorship of an uncemented modular stem (MRP-Titan) in revision for PHF is significantly reduced by episodes of instability.

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使用非骨水泥模块化锥形柄翻修温哥华B型假体周围骨折的回顾性生存分析。不稳定性会威胁存活率吗?
简介和目的:髋关节假体周围骨折的发生率和复杂性不断增加,这对外科医生来说是一项挑战。我们旨在评估非骨水泥模块化锥形柄治疗温哥华B2和B3型假体周围骨折的存活率,并回顾与存活率下降相关的主要并发症和因素。材料和方法:我们对使用非骨水泥模块化凹槽锥形柄(MRP-Titan)治疗温哥华B2和B3型假体周围股骨干骨折而接受翻修关节成形术的患者进行了回顾性研究。对人口统计学和放射学参数进行了分析。采用 Kaplan-Meier 存活率分析法计算了 2 年和 5 年的存活率(无须再次手术):结果:共纳入 39 名患者,平均年龄为 73.5 岁,平均随访时间为 5 年。关节置换术后 2 年的存活率为 73.7%,5 年的存活率为 67.5%(平均 8.4 年;范围 6.7-10.2)。不稳定性发作患者的存活率较低(平均为 2.5 年;范围为 0-5.42)(p 结论:非骨水泥模块化骨干(MRP-Titan)在PHF翻修中的存活率会因不稳定性发作而显著降低。
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来源期刊
CiteScore
1.10
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0.00%
发文量
156
审稿时长
51 weeks
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