Femoral shaft fractures after cemented total hip arthroplasty

García-Cimbrelo, Eduardo; Munuera, L.; Gil-Garay, E.

doi:10.1007/bf00182995

Cited by 52 publications

(15 citation statements)

References 13 publications

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“…[34][35][36][37][38][39][40] In the present study, the prevalence of periprosthetic fracture was 2 of 35 hips (5.7%), and the fractures occurred around 2 cementless femoral stems. No periprosthetic fracture occurred around the cemented femoral stems.…”

Section: Limitationsmentioning

confidence: 78%

Total hip arthroplasty in steroid-induced osteonecrosis: early functional and radiological outcomes

2013

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RESEARCH • RECHERCHE Total hip arthroplasty in steroid-induced osteonecrosis: early functional and radiological outcomesBackground: The proportion of total hip arthroplasties (THAs) associated with corticosteroid use is uncertain, and the mechanisms of corticosteroid-induced osteonecrosis remain unknown. We sought to evaluate the clinical and radiographic outcomes, complications and satisfaction with THA among patients with corticosteroid-induced osteonecrosis. Methods:We retrospectively assessed functional outcome at a minimum 1-year follow-up using the Western Ontario and MacMaster Universities Arthritis Index (WOMAC); Oxford Hip Score; Short Form (SF)-12; University of California, Los Angeles (UCLA) Activity; and patient satisfaction scores. Results:We included 31 patients (35 hips). The average follow-up was 20 (range 12-55) months, and the average age at surgery was 47 (range 19-78) years. At follow-up, patients showed significant improvement in all 4 components of the WOMAC (means: function 84, stiffness 75, pain 86, global 84), Oxford-12 (mean 83) and SF-12 (means: mental 40 and physical 48) scores. However, there was no significant improvement in the UCLA Activity scores. Mean patient satisfaction scores were good for pain relief (86), function (80), recreation (77.5) and overall results of surgery (86). Radiographic review at follow-up showed that all components were well fixed with no evidence of loosening. The complication rate was high (17%), with 6 complications in 5 patients (6 of 35 hips). Four patients (4 of 35 hips; 11%) required reoperations. Conclusion:Total hip arthroplasty in patients with corticosteroid-induced osteonecrosis of the femoral head is successful in reducing pain and improving function; however, the rate of complications and reoperation is high.

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Section: Limitationsmentioning

confidence: 78%

Total hip arthroplasty in steroid-induced osteonecrosis: early functional and radiological outcomes

2013

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“…Clinical studies, however, have shown that cerclage fixation alone is not rigid enough, and that it should be supplemented with other methods of internal fixation (Garcia-Cimbrelo et al 1992). DCPs can be fixed around a stable stem with unicortical screws, with or without cerclage wires or cables, and with bicortical screws below it.…”

Section: Discussionmentioning

confidence: 99%

Dynamic compression plates for Vancouver type B periprosthetic femoral fractures

et al. 2005

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Background There is no consensus on the best surgical treatment of periprosthetic femoral fractures. We report our experience with a dynamic compression plate.Patients and methods We reviewed the results of 18 periprosthetic femoral fractures treated with open reduction and internal fixation using the dynamic compression plate (DCP). There were 7 Vancouver type B1, 2 type B2 and 9 type B3 fractures. 16 cases had previously undergone at least one revision procedure. In addition to a DCP plate, all B2 and B3 fractures were revised to cemented prostheses, and all B3 fractures were revised with impaction grafting. Mean follow-up was 39 months.Results The mean healing time for those 11 cases that united was 13 months. One B1-type and one B3-type fracture with plate fracture within 8 months of surgery failed to heal. Furthermore, one B1-type fracture and one B2-type fracture failed and developed nonunion. 3 patients died, from causes not related to surgery, within 8 months after surgery without signs of healing.Interpretation Open reduction and internal fixation using DCPs seems to be a valid method for the treatment of postoperative periprosthetic femoral fractures with stable stem in place. If the stem is unstable, we suggest that DCPs may be used in association with femoral revision using a long stem. In cases with stable stem (B1), we are inclined to agree with other authors that additional fixation using an extramedullary cortical strut graft may be necessary to improve stability and promote final healing.

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“…Jed nym z nich są zła ma nia oko ło pro te zowe ko ści udo wej sta no wią ce, we dług szwedz kie go naro do we go re je stru pro tez sta wu bio dro we go z 2010 r., trze cią co do czę sto ści wy stę po wa nia przy czy nę opera cji re wi zyj nych po alo pla sty kach sta wu bio dro wego (9,5%), po asep tycz nym ob lu zo wa niu wsz cze pu (60,1%) i na wra ca ją cych zwi ch nię ciach pro te zy (13,1%) [2,3]. Czę stość wy stę po wa nia zła mań około pro te zo wych wy no si 1% -3% po alo pla sty kach cał ko wi tych ce men to wa nych [4], 3% -7% po bez cemen to wych [5] oraz 2,1% po ope ra cjach re wi zyjnych [3]. Czyn ni ka mi pre dys po nu ją cy mi do ich wystą pie nia są m.in.…”

Section: Wstępunclassified

“…Complications from hip replacement procedures include periprosthetic femoral fractures, which according to the Swedish Hip Arthroplasty Register of 2010, are the third most common cause of revision surgeries after hip arthroplasty (9.5%), following aseptic implant loosening (60.1%) and recurrent prosthesis dislocation (13.1%) [2,3]. Periprosthetic fractures occur in 1-3% of patients after total cemented hip replacement [4], 3-7% of those after cementless arthroplasty [5], and 2.1% of patients after revision surgeries [3]. Predisposing factors include osteoporosis, past surgery of the proxi mal femur (bone screw holes, deformation), periprosthetic osteolysis secondary to implant loosening, and internal and neurological co-morbidities which predispose patients to falls from standing height [6].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Treatment of Periprosthetic Femoral Fractures after Total Hip Replacement – Experience of Department of Orthopedics and Traumatology, Medical University of Warsaw

Łęgosz

Krawczak

Szczęsny

2014

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Wraz z ro sną cą licz bą wy ko ny wa nych alo pla styk sta wu bio dro we go, wzra sta licz ba zła mań oko ło pro te zo wych ko ści udo wej. Ce lem pra cy by ła oce na wy ni ków le cze nia zła mań oko ło pro te zo wych przy uży ciu funk cjo nal nej ska li Harris Hip Sco re (HHS). W przed sta wio nym ba da niu do ko na no po rów na nia wy ni ków le cze nia zła mań oko ło pro te zo wych z wy ni ka mi le cze nia sprzed wy stą pie nia zła ma nia, uzy ski wa ny mi w trak cie kon tro li am bu la to ryj nych.Ma te riał i me to dy. Do ba da nia włą czo no 65 cho rych, któ rych po dzie lo no na czte ry gru py w za le żno ści od ty pu prze prowa dzo ne go za bie gu pier wot ne go: pierw szą gru pę sta no wi li cho rzy ze zła ma nia mi oko ło pro te zo wy mi ko ści udo wej po im planta cji pro te zy po ło wi czej, dru gą po alo pla sty ce cał ko wi tej ce men to wa nej, trze cią gru pę sta no wi li pa cjen ci po alo pla sty ce bezce men to wej, czwar tą po re alo pla sty ce sta wu bio dro we go. Do kla sy fi ka cji ty pu zła ma nia uży to ska li Van co uver.Wy ni ki. U wszyst kich cho rych, w czte rech ba da nych gru pach, stwier dzo no na pod sta wie kwe stio na riu sza HHS po gorsze nie wy ni ków le cze nia w po rów na niu z wy ni ka mi uzy ski wa ny mi przed wy stą pie niem zła ma nia. Naj więk sze po gor szenie funk cjo nal nych wy ni ków le cze nia ob ser wo wa no w gru pie cho rych po alo pla sty ce po ło wi czej i cementowej.Wnio ski. 1. Wy ni ki le cze nia zła mań oko ło pro te zo wych oce nia nych wg ska li HHS są gor sze w po rów na niu ze sta nem sprzed wy stą pie nia zła ma nia. 2. Do bre wy ni ki le cze nia zła mań oko ło pro te zo wych uzy ska no je dy nie w le cze niu zła mań typu B1 wg kla sy fi ka cji Van co uver. 3. Wy stę po wa nie cho rób współ ist nie ją cych u osób w po de szłym wie ku wpły wa na słab szy wy nik osta tecz ny le cze nia zła mań oko ło pro te zo wych Słowa kluczowe: złamanie okołoporotezowe, aloplastyka stawu biodrowego, zabiegi rewizyjne, kwestionariusz HHS, analiza funkcjonalna SUMMARY Background. As more and more hip replacement procedures are being performed, the incidence of periprosthetic femoral fractures is also growing. The aim of the study was to assess the outcomes of periprosthetic fracture treatment with the use of the functional Harris Hip Score (HHS). It compares the outcomes of periprosthetic fracture treatment and prefracture treatment results obtained during follow-up outpatient consultations.Material and methods. The study involved 65 patients divided into the following four groups, depending on the type of the primary procedure: patients with periprosthetic femoral fractures after hip hemiarthroplasty; patients after cemented total hip replacement; patients after cementless arthroplasty; and patients after revision hip arthroplasty. The types of fractures were classified according to the Vancouver scale.Results. The HHS questionnaires showed a deterioration of treatment outcomes in all patients from the four groups as compared with the outcomes obta...

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Femoral shaft fractures after cemented total hip arthroplasty

Cited by 52 publications

References 13 publications

Total hip arthroplasty in steroid-induced osteonecrosis: early functional and radiological outcomes

Total hip arthroplasty in steroid-induced osteonecrosis: early functional and radiological outcomes

Dynamic compression plates for Vancouver type B periprosthetic femoral fractures

Outcomes of Treatment of Periprosthetic Femoral Fractures after Total Hip Replacement – Experience of Department of Orthopedics and Traumatology, Medical University of Warsaw

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