Femoral neck fractures following Birmingham hip resurfacing

Shimmin, A; Back, Diane

doi:10.1302/0301-620x.87b4.15498

Cited by 391 publications

(288 citation statements)

References 8 publications

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“…Several authors gave special consideration to male patients older than 65 years on a case-by-case basis depending on bone quality and patient activities [30,53,58,61,78], and one study included male patients up to age 89 years [68]. Conversely, several articles [2-4, 53, 63, 66, 77-79] believed female patients should be cautiously evaluated before performing hip resurfacing on them, especially if they are postmenopausal or have decreased bone mineral density [79].…”

Section: Age and Gendermentioning

confidence: 99%

“…The largest pooled multicenter numbers come from the Australian registry, in which the data suggest hip resurfacing has fewer complications when performed on men younger than 65 years of age and women younger than 55 years [29,79]. Shimmin and Back [79] reviewed the Australian registry and identified 50 cases of femoral neck fractures (1.49%) in 3429 hip resurfacing procedures over a 4-year period.…”

Section: Age and Gendermentioning

confidence: 99%

“…Shimmin and Back [79] reviewed the Australian registry and identified 50 cases of femoral neck fractures (1.49%) in 3429 hip resurfacing procedures over a 4-year period. The overall rate of fracture was 0.98% for men and almost double that for women (1.91%).…”

Section: Age and Gendermentioning

confidence: 99%

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Is Patient Selection Important for Hip Resurfacing?

Nunley¹,

Valle²,

Barrack³

2009

Clinical Orthopaedics &Amp; Related Research

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The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short-and midterm clinical results (1-to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review, we believe the best candidates for hip resurfacing are men under age 65 with osteoarthritis and relatively normal bony morphology. Level of Evidence: Level V, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Age and Gendermentioning

confidence: 99%

Section: Age and Gendermentioning

confidence: 99%

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Is Patient Selection Important for Hip Resurfacing?

Nunley¹,

Valle²,

Barrack³

2009

Clinical Orthopaedics &Amp; Related Research

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“…The clinical outcomes of hip resurfacing are extremely sensitive to patient selection [1,3,9,13,28,32] and the technical details of the surgical technique [9,30,36,43,44]. It is well established that notching of the femoral neck, exposed cancellous bone, and varus placement of the femoral component increase the likelihood of femoral neck fracture [5,9,27,36,43].…”

mentioning

confidence: 99%

The Learning Curve for Adopting Hip Resurfacing Among Hip Specialists

Nunley

Zhu

Brooks

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Patient demand and surgeon interest in hip resurfacing has recently increased, but surgeons in the United States are relatively inexperienced with this procedure. We determined the learning curve associated with hip resurfacing and compared the rate of early complications of the first 650 hip resurfacings between five experienced hip surgeons and a national safety survey database study we previously published, which included 89 surgeons and 537 hip resurfacings. Patient demographics and adverse events were recorded. Specific features on pre-and postoperative radiographs were measured in a blinded fashion by a single observer. There were 13 major complications (2.0%), which is 3.7 times lower than our national safety survey complication rate of 7.4%. All fractures occurred in the first 25 cases performed. The complication rate was higher for the first 25 procedures (5.6%) compared with the second 25 procedures (1

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“…Extensive clinical results and registry data shows that the risk of femoral neck fracture is greatest during the postoperative recovery period. This is thought to be linked to incorrect implant positioning, intraoperative bone damage from osteotomy and impaction loads, and bone cement exotherm, amongst other factors Shimmin and Back 2005). In that case it is logical that numerical investigations of this complication should be accounting for the fact that BMD drops postoperatively before recovering, as this would be expected to contribute further to temporarily elevated periprosthetic bone strain and fracture risk.…”

Section: Discussionmentioning

confidence: 99%

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Dickinson

2015

Biomech Model Mechanobiol

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Bone morphology and density changes are commonly observed following joint replacement, and may contribute to the risks of implant loosening and periprosthetic fracture, and reduce the available bone stock for revision surgery. This study was presented in the "Bone and Cartilage Mechanobiology across the scales" WCCM symposium to review the development of remodelling prediction methods and to demonstrate simulation of adaptive bone remodelling around hip replacement femoral components, incorporating intrinsic (prosthesis) and extrinsic (activity and loading) factors.An iterative bone remodelling process was applied to finite element models of a femur implanted with a cementless THR (total hip replacement) and a hip resurfacing implant. Previously developed for a cemented THR implant, this modified process enabled the influence of pre-to postoperative changes in patient activity and joint loading to be evaluated. A control algorithm used identical pre-and postoperative conditions, and the predicted extents and temporal trends of remodelling were measured by generating virtual x-rays and DXA scans.The modified process improved qualitative and quantitative remodelling predictions for both the cementless THR and resurfacing implants, but demonstrated the sensitivity to DXA scan region definition and appropriate implant-bone position and sizing. Predicted remodelling in the intact femur in response to changed activity and loading demonstrated that in this simplified model, although the influence of the extrinsic effects were important, the mechanics of implantation were dominant. This study supports the application of predictive bone remodelling as one element in the range of physical and computational studies, which should be conducted in the pre-clinical evaluation of new prostheses.

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Femoral neck fractures following Birmingham hip resurfacing

Cited by 391 publications

References 8 publications

Is Patient Selection Important for Hip Resurfacing?

Is Patient Selection Important for Hip Resurfacing?

The Learning Curve for Adopting Hip Resurfacing Among Hip Specialists

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

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