Can We Predict Fracture When Using a Short Cementless Femoral Stem in the Anterior Approach?

McGoldrick, Niall P; Cochran, M; Biniam, Brook; Bhullar, Raman S; Beaulé, Paul E.; Kim, Paul; Gofton, Wade; Grammatopoulos, George

doi:10.1016/j.arth.2022.03.054

Cited by 6 publications

(2 citation statements)

References 30 publications

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“…It did, however, identify proximal femur morphology, as categorised by the Dorr classification, to be associated with increased risk of revision arthroplasty. This is in keeping with recent work from McGoldrick et al 20 who illustrated that a canal flare index (CFI) >3.17 can serve as a predictor of early fracture when using short, collarless stems. Whether surgical approach is associated with PPF remains unclear; there is some evidence to suggest an increased risk of PPF during an anterior approach THA.…”

Section: Discussionsupporting

confidence: 89%

Early- to mid-term outcome of a short, cementless, titanium, flat, tapered stem for primary total hip arthroplasty: an independent series

Bourget-Murray,

Biniam,

Bhullar

et al. 2023

HIP International

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Introduction: This study aims to: (1) describe perioperative complications amongst patients who underwent primary total hip arthroplasty (THA) using a short cementless, titanium, flat, tapered stem; (2) estimate this stem’s early- to mid-term survival; (3) identify factors associated with revision arthroplasty; and (4) describe femoral remodelling at minimum 6 years postoperatively. Methods: A retrospective review of consecutive patients who underwent THA using a Taperloc Microplasty stem (Zimmer-Biomet, Warsaw, Indiana, USA) with minimum 2-year follow-up was performed. Surgeries were performed by 1 of 6, non-designer, arthroplasty surgeons between 2014 and 2018. Outcomes included perioperative complications including revision arthroplasty, and survival. Cox analysis was used to analyse the effect of different factors on risk of revision arthroplasty. Radiographs with 6-year follow-up served to describe femoral remodelling. Results: In 1205 patients, followed for 5.1 ± 1.4 years, the incidence of perioperative complication was 5.2% for which 29 patients (2.4%) required revision arthroplasty. The 5- and 7-year survival rates were 97.8% (95% CI, 96.9–98.5) and 97.0% (95% CI, 95.6–98.0), respectively. The only factor associated with revision arthroplasty was proximal femur morphology, as per Dorr classification (HR 1.24 [95%CI, 1.09–1.41]; p = 0.005). During radiographic assessment, 12% of patients showed ⩾25% of relative change in cortical thickness in Gruen zones 3 or 5. We observed calcar remodelling in 50% of radiographs while 10% showed presence of a pedestal sign. Conclusions: The 7-year survivorship of the Taperloc Microplasty stem is within National Institute for Health and Care Excellence (NICE) guidelines. Patients ⩽65 years with osteoarthritis and Dorr A/B femoral morphology may be ideal candidates for THA with this stem. Femoral remodelling is common and not associated with adverse outcome.

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Section: Discussionsupporting

confidence: 89%

Early- to mid-term outcome of a short, cementless, titanium, flat, tapered stem for primary total hip arthroplasty: an independent series

Bourget-Murray,

Biniam,

Bhullar

et al. 2023

HIP International

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“…For the anterior approach, the reported rate ranges between 1.0 and 2.2% in multiple papers, with a little over half requiring fixation. Calcar fractures should be treated with cerclage and greater trochanter fractures with observation 19,20 (Figure 5).…”

Section: Intraoperative Fracturesmentioning

confidence: 99%

Complicaciones del abordaje anterior directo en artroplastía total de cadera

Fernández-Palomo,

González-Pola

2023

Acta Ortopédica Mexicana

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The direct anterior approach (DAA) for total hip arthroplasty has been popularized in the last decade as a minimally invasive approach used by many surgeons, including the authors, to preserve the integrity of muscle groups and their insertions and the dynamic hip stability resulting in less surgical trauma and faster recovery process with decreased postoperative pain. This surgical approach is not without a variety of complications and pitfalls. This review aims to identify any potential drawbacks and challenges associated with the DAA in THA and guide surgeons on minimizing and avoiding them.

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Periprosthetic fracture following anterior approach or dislocation after posterior approach: which one is the lesser evil?

Verhaegen,

Schmidt-Braekling,

Wei

et al. 2023

Arch Orthop Trauma Surg

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Can We Predict Fracture When Using a Short Cementless Femoral Stem in the Anterior Approach?

Cited by 6 publications

References 30 publications

Early- to mid-term outcome of a short, cementless, titanium, flat, tapered stem for primary total hip arthroplasty: an independent series

Early- to mid-term outcome of a short, cementless, titanium, flat, tapered stem for primary total hip arthroplasty: an independent series

Complicaciones del abordaje anterior directo en artroplastía total de cadera

Periprosthetic fracture following anterior approach or dislocation after posterior approach: which one is the lesser evil?

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