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Distal femoral arthroplasty for native knee fractures : results from the Australian Orthopaedic Association National Joint Replacement Registry.
The Bone & Joint Journal ( IF 4.9 ) Pub Date : 2022-07-01 , DOI: 10.1302/0301-620x.104b7.bjj-2021-1136.r3
Andrea S Aebischer 1 , Raphael Hau 2, 3 , Richard N de Steiger 4, 5 , Carl Holder 6 , Christopher J Wall 1, 7
Affiliation  

AIMS The aim of this study was to investigate the rate of revision for distal femoral arthroplasty (DFA) performed as a primary procedure for native knee fractures using data from the Australian Orthopaedic Association National Joint Arthroplasty Registry (AOANJRR). METHODS Data from the AOANJRR were obtained for DFA performed as primary procedures for native knee fractures from 1 September 1999 to 31 December 2020. Pathological fractures and revision for failed internal fixation were excluded. The five prostheses identified were the Global Modular Arthroplasty System, the Modular Arthroplasty System, the Modular Universal Tumour And Revision System, the Orthopaedic Salvage System, and the Segmental System. Patient demographic data (age, sex, and American Society of Anesthesiologists grade) were obtained, where available. Kaplan-Meier estimates of survival were used to determine the rate of revision, and the reasons for revision and mortality data were examined. RESULTS The AOANJRR identified 153 primary DFAs performed for native knee fractures in 151 patients during the study period, with 63.3% of these (n = 97) performed within the last five years. The median follow-up was 2.1 years (interquartile range 0.8 to 4.4). The patient population was 84.8% female (n = 128), with a mean age of 76.1 years (SD 11.9). The cumulative percent revision rate at three years was 10%. The most common reason for revision was loosening, followed by infection. Patient survival at one year was 87.5%, decreasing to 72.8% at three years postoperatively. CONCLUSION The use of DFA to treat native knee fractures is increasing, with 63.3% of cases performed within the last five years. While long-term data are not available, the results of this study suggest that DFA may be a reasonable option for elderly patients with native knee fractures where fixation is not feasible, or for whom prolonged non-weightbearing may be detrimental. Cite this article: Bone Joint J 2022;104-B(7):894-901.

中文翻译:

本地膝关节骨折的股骨远端关节置换术:来自澳大利亚骨科协会国家关节置换登记处的结果。

目的 本研究的目的是使用来自澳大利亚骨科协会全国关节置换术登记处 (AOANJRR) 的数据,调查作为天然膝关节骨折主要手术的股骨远端关节置换术 (DFA) 的翻修率。方法 AOANJRR 的数据是从 1999 年 9 月 1 日至 2020 年 12 月 31 日期间作为原生膝关节骨折的主要手术进行的 DFA 获得的。排除了病理性骨折和因内固定失败而进行的翻修。确定的五种假体是全球模块化关节成形术系统、模块化关节成形术系统、模块化通用肿瘤和翻修系统、骨科抢救系统和节段系统。获得了可用的患者人口统计数据(年龄、性别和美国麻醉医师协会等级)。Kaplan-Meier 生存率估计用于确定翻修率,并检查翻修原因和死亡率数据。结果 AOANJRR 在研究期间确定了 151 名患者的 153 项原发性 DFA,其中 63.3%(n = 97)在过去五年内进行。中位随访时间为 2.1 年(四分位距 0.8 至 4.4)。患者人群为 84.8% 的女性(n = 128),平均年龄为 76.1 岁(SD 11.9)。三年的累积百分比修订率为 10%。最常见的翻修原因是松动,其次是感染。患者一年的生存率为 87.5%,术后三年降至 72.8%。结论 使用 DFA 治疗天然膝关节骨折的情况正在增加,63.3% 的病例在过去五年内进行。虽然长期数据不可用,但本研究的结果表明,对于无法进行固定或长期不负重可能有害的患有天然膝关节骨折的老年患者,DFA 可能是一个合理的选择。引用这篇文章:骨关节 J 2022;104-B(7):894-901。
更新日期:2022-07-01
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