High incidence of complications and poor clinical outcome in the operative treatment of periprosthetic femoral fractures Zuurmond, R.G.; van, Wijhe W.; van Raay, J.J.; Bulstra, Sjoerd K. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Total hip arthroplasty (THA) is among the most successful operative procedures known to medicine, because of which the prevalence of this procedure is rapidly increasing. However, with the success the downside becomes increasingly important as well: the complications associated with THA. Although the number of serious complications on the long term is low, a serious complication is the periprosthetic fracture (PPF) of the femur. Often, these fractures occur in older, compromised patients, raising mortality rates. 10 The increase in the number of patients treated with THA, as well as people getting older, create a large population 'at risk'. In the literature, the increasing incidence of PPF has been reported by a number of study groups. 7,15Several retrospective studies have been published, however, with limited information on clinical outcomes. 1,11,16 Using the Swedish Arthroplasty Register, Lindahl et al. were able to report a large prospective series and identify risk factors for PPF (e.g., stem design). 8 Derived from questionnaires at follow-up, their patients showed an impaired hip function and low health status. We performed a retrospective study in two hospitals and included the Oxford hip score questionnaire and a review of the complete radiologic follow-up. According to clinical observations and literature reports, we expected high major complication rates, especially re-operations. Osteosynthesis performed for Vancouver type-B fractures were expected to have a high failure rate as previously described in literature reports. We posed the following research questions: Does the treated PPF population show a high complication rate? Do these patients show an impaired functional outcome and is this influenced by the method of treatment? Background:The purpose of this observational study was to determine the clinical results of the operative treatment of periprosthetic femoral fractures over a long period of time. Methods: The medical records of patients treated between 1993 and 2006 for a periprosthetic femoral fracture were obtained after a survey in two major hospitals. Radiographic evaluation was performed according to the Vancouver classification. All patients were contacted to fill out the Oxford hip score. Results: A total of 80 PPFs were identified in 79 patients. For 71 patients with 71 fractures, medical records and radiographs were available. The mean age at the time of fracture was 73.4 years (range: 38-95 years). The mean interv...

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Pseudotumor formation occurred in 28% of hips after an average follow-up of forty-one months. Most pseudotumors (72.5%) were asymptomatic. Larger pseudotumors were associated with more complaints. Survival analysis showed an implant survival of 87.5% at five years. Failure occurred in 5.6% (eight) of 143 hips because of a symptomatic pseudotumor.

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The Oxford phase III unicompartmental knee replacement in patients less than 60 years of age Kort, Nanne P.; van Raay, Jos J. A. M.; van Horn, Jim J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 11-05-2018Abstract Treatment of younger patients with medial unicompartmental disease of the knee joint remains a challenging therapeutic dilemma. With the refinement of implant design, fixation and the minimally invasive techniques employed with unicompartmental knee replacement, indications have expanded to include its use in young patients. A prospective cohort of 46 unicompartmental knee procedures were performed with a 2-year minimum and 6-year maximum followup, using the Oxford phase III unicompartmental knee arthroplasty, in the younger patient group (age 60 or younger). We conclude that the unicompartmental knee arthroplasty is an important option for the treatment of medial compartment disease for patients 60 years or younger. Obesity can cause technical difficulties, increased risk of complications and early failure of this prosthesis.