Who Is Treating Periprosthetic Femur Fractures? An Analysis of the Periprosthetic Research Consortium

IF 1.5 Q3 ORTHOPEDICS Arthroplasty Today Pub Date : 2024-08-13 DOI:10.1016/j.artd.2024.101428
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引用次数: 0

Abstract

Background

Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based on surgical training or patient factors.

Methods

This multicenter retrospective study evaluated patients surgically treated for Vancouver B PPFF after THA between 2014 and 2019. Patients from 11 academic centers located in the United States were included in this study. Surgical outcomes and patient demographics were evaluated based on surgeon training, surgical treatment type, and institution.

Results

Presence of Vancouver B2 (odds ratio [OR]: 0.02, P < .001) or B3 (OR: 0.04, P < .001) fractures were independent risk factors for treatment with rTHA. Treatment by a trauma (OR: 12.49, P < .001) or other-specified surgeon (OR: 13.63, P < .001) were independent risk factors for ORIF repair of Vancouver B fractures. There were no differences in outcomes based on surgeon subspecialty training.

Conclusions

This study showed the trends in surgeons who surgically manage Vancouver B fractures at 11 major academic institutions and highlighted that regardless of surgical training or surgical treatment type, postoperative outcomes following management of PPFF were similar.

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谁在治疗股骨假体周围骨折?假体周围研究联盟分析
背景全髋关节置换术(THA)后股骨假体骨折(PPFF)在过去十年中有所增加,因为对初次手术的需求持续增长。尽管现在有更多的证据来描述范库弗B型骨折的治疗方法,但对于导致外科医生实施开放复位内固定术(ORIF)或翻修THA(rTHA)的因素,人们的了解仍然有限。本研究的目的是确定 11 家主要学术机构中治疗温哥华 B 型 PPFF 的外科医生类型,以及是否存在基于外科培训或患者因素的 ORIF 或 rTHA 治疗决策趋势。方法这项多中心回顾性研究评估了 2014 年至 2019 年间 THA 后接受手术治疗的温哥华 B 型 PPFF 患者。本研究纳入了来自美国 11 个学术中心的患者。根据外科医生培训、手术治疗类型和机构对手术结果和患者人口统计学进行了评估。结果存在温哥华 B2(几率比 [OR]:0.02,P < .001)或 B3(OR:0.04,P < .001)骨折是使用 rTHA 治疗的独立风险因素。由外伤(OR:12.49,P < .001)或其他指定外科医生(OR:13.63,P < .001)治疗是温哥华 B 型骨折 ORIF 修复的独立危险因素。结论这项研究显示了 11 家主要学术机构中对温哥华 B 型骨折进行手术治疗的外科医生的趋势,并强调无论外科培训或手术治疗类型如何,PPFF 治疗后的术后结果都是相似的。
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来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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