One year after proximal or distal periprosthetic fracture of the femur -two conditions with divergent outcomes?

被引:23
作者
Eschbach, D. [1 ]
Buecking, B. [1 ]
Kivioja, H. [1 ]
Fischer, M. [1 ]
Wiesmann, T. [2 ]
Zettl, R. [3 ]
Oberkircher, L. [1 ]
Barthel, J. [1 ]
Aigner, R. [1 ]
Ruchholtz, S. [1 ]
Bliemel, C. [1 ]
机构
[1] Univ Hosp Giessen & Marburg, Ctr Orthoped & Trauma Surg, Marburg, Germany
[2] Univ Hosp Giessen & Marburg, Dept Anesthesiol & Intens Care Med, Marburg, Germany
[3] Kantonsspital Frauenfeld, Dept Orthopaed & Trauma Surg, CH-8500 Frauenfeld, Switzerland
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2018年 / 49卷 / 06期
关键词
Periprosthetic fracture; Knee associated periprosthetic fracture; Hip associated periprosthetic fracture; Geriatric fracture; TOTAL KNEE ARTHROPLASTY; QUALITY-OF-LIFE; TOTAL HIP; FEMORAL FRACTURES; PLATE; CLASSIFICATION; PERSPECTIVE; RISK; PAIN;
D O I
10.1016/j.injury.2018.04.025
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to prefracture mobility. Methods: Prospective single-centre observation study of periprosthetic femoral fractures with stable implants. Present subgroup analysis includes patients with PFTKA and PFTHA. All patients were treated with polyaxial angular stable plates using two standardized techniques: a minimally invasive percutaneous distal insertion technique and a mini-open technique. Data collection included implantand operation-related information as well as demographics, clinical course, complications and return to pre-fracture mobility. Data were collected during a 12-month follow-up. Results: We were able to analyse the data of 73 patients. The PFTKA group had 37 patients with a mean age of 76 +/- 10 years; 88% were female. After 1 year, 3 patients in this cohort had died; 68% of survivors had reached their pre-fracture mobility; 22% had undergone operative revisions for various reasons. The PFTHA cohort included 36 patients with a mean age of 80 +/- 13 years, 72% were female. After 1 year, 9 patients had died in this cohort, 42% of survivors had reached their pre-fracture mobility. Non-operative complications occurred for 16% in the PFTKA group and 64% in the PFTHA group (p < 0.001). 11% had undergone operative revisions for various reasons, among them, two cases of nonunion but no primary infection. Conclusion: On average, compared to the PFTHA patients, PFTKA patients were younger, underwent significantly lower rates of non-operative complications, had a tendency towards lower mortality, and returned to pre-fracture mobility at higher rates, although they tended to have more revisions when compared to treatment for PFTHA. Overall, when periprosthetic fractures of the femur were treated using polyaxiallockingplate osteosynthesis, patients showed very low ratesofnonunion and no primary infection. (C) 2018 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1176 / 1182
页数:7
相关论文
共 34 条
[1]   A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery [J].
Bachmeier, CJM ;
March, LM ;
Cross, MJ ;
Lapsley, HM ;
Tribe, KL ;
Courtenay, BG ;
Brooks, PM .
OSTEOARTHRITIS AND CARTILAGE, 2001, 9 (02) :137-146
[2]  
Beals RK, 1996, CLIN ORTHOP RELAT R, P238
[3]   Comparing Patient Outcomes After THA and TKA Is There a Difference? [J].
Bourne, Robert B. ;
Chesworth, Bert ;
Davis, Aileen ;
Mahomed, Nizar ;
Charron, Kory .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (02) :542-546
[4]  
Buecking B., 2013, OUP, V2, P259
[5]  
Chen F, 1994, J ARTHROPLASTY, V9, P251
[6]   Comparison of Total Hip and Knee Arthroplasty Cohorts and Short-Term Outcomes From a Single-Center Joint Registry [J].
Choi, Jung Keun ;
Geller, Jeffery A. ;
Yoon, Richard S. ;
Wang, Wenbao ;
Macaulay, William .
JOURNAL OF ARTHROPLASTY, 2012, 27 (06) :837-841
[7]   Patient Perspective Survey of Total Hip vs Total Knee Arthroplasty Surgery [J].
de Beer, Justin ;
Petruccelli, Danielle ;
Adili, Anthony ;
Piccirillo, Liz ;
Wismer, David ;
Winemaker, Mitch .
JOURNAL OF ARTHROPLASTY, 2012, 27 (06) :865-869
[8]   NCB-plating in the treatment of geriatric and periprosthetic femoral fractures [J].
El-Zayat, B. F. ;
Ruchholtz, S. ;
Efe, T. ;
Fuchs-Winkelmann, S. ;
Krueger, A. ;
Kreslo, D. ;
Zettl, R. .
ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, 2012, 98 (07) :765-772
[9]   Treatment of periprosthetic femur fractures with the non-contact bridging plate: a new angular stable implant [J].
Erhardt, J. B. ;
Grob, K. ;
Roderer, G. ;
Hoffmann, A. ;
Forster, T. N. ;
Kuster, M. S. .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2008, 128 (04) :409-416
[10]   Risk factors for periprosthetic femoral fracture [J].
Franklin, John ;
Malchau, Henrik .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2007, 38 (06) :655-660