Stem revision vs. internal fixation in vancouver B2/B3 periprosthetic hip fractures: systematic review and metanalysis

被引:4
作者
Di Martino, Alberto [1 ,2 ]
Brunello, Matteo [1 ,2 ]
Villari, Eleonora [1 ,2 ]
D'Agostino, Claudio [1 ,2 ]
Cosentino, Monica [3 ]
Bordini, Barbara [3 ]
Rivera, Fabrizio [4 ]
Faldini, Cesare [1 ,2 ]
机构
[1] IRCCS Ist Ortoped Rizzoli, Orthoped & Traumatol Dept 1, I-40136 Bologna, Italy
[2] Univ Bologna, Dept Biomed & Neurimotor Sci DIBINEM, I-40136 Bologna, Italy
[3] IRCCS Ist Ortoped Rizzoli, Med Technol Lab, I-40136 Bologna, Italy
[4] SS Annunziata Hosp, Dept Orthoped Trauma, I-12038 Savigliano, Italy
关键词
Periprosthetic fracture; Vancouver classification; B2; B3; THA revision; Fixation; ORIF; FEMORAL FRACTURES; OPEN REDUCTION; ARTHROPLASTY; B2; CLASSIFICATION; MORTALITY; OUTCOMES;
D O I
10.1007/s00402-024-05469-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
IntroductionVancouver B2 and B3 periprosthetic fractures (PFF) are associated with stem instability and often require a demanding stem implant revision (SR) or internal fixation (ORIF). This latter surgery is increasingly performed in the last few years instead of SR, but it is unclear which is the best treatment to manage PFF patients. The aim of this study is the compare the outcomes of B2/B3 PFF managed by either ORIF or SR, by performing a systematic review and meta-analysis of current literature.Materials and methodsCochrane Database, PubMed, Google Scholar and MEDLINE were examined to find out relevant publications dealing with the different outcomes of SR vs. ORIF in B2/B3 PFF of the hip. The effect model (EM) was calculated using Cohen<acute accent>s d index.ResultsFifteen studies were included, reporting on a total of 1629 patients (564 ORIF and 1065 SR). The pooled random EM estimates for reoperation was 0.87 (95% CI, 0.39-1.96; I2 = 78%) in favor of ORIF surgery; EM for complications was 1.01 (95% CI, 0.45-2.27; I2 = 85%) without difference among procedures. The EM for transfusion was 0.72 (95% CI, 0.46-1.12; I2 = 62%) in favor of fixation.ConclusionORIF and SR were both suitable and effective options in PFF patients, being associated to similar complications rates. Our results show that ORIF performance in PFF patients is associated to significantly less in blood loss, surgical time and in-hospital stay. These advantages are particularly appealing in patients with multiple comorbidities.
引用
收藏
页码:3787 / 3796
页数:10
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