Heterotopic ossification after hemiarthroplasty of the hip – A comparison of three common approaches

Corrigan, Chad; Greenberg, Sarah E.; Sathiyakumar, Vasanth; Mitchell, Phillip M.; Francis, Arie; Omar, Adan; Thakore, Rachel V.; Obremskey, William T.; Sethi, Manish K.

doi:10.1016/j.jcot.2014.11.004

Cited by 15 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are several factors involved in HO, including hypertrophic osteoarthritis, ankylosing spondylitis, and male gender 63 64) . Among them, surgical approach is one of the important factors that cause HO 63) . Compared to anterior or anterolateral approaches, the posterior approach to the hip joint involves less abductor manipulation, which may influence the occurrence of HO.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

et al. 2018

View full text Add to dashboard Cite

PurposeThis study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies.Materials and MethodsSystematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types.ResultsThere were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03).ConclusionCemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Some studies have reported dislocation rates as high as 9%-13% with the posterior approach, although a recent meta-analysis of 13,000 patients found this rate to be closer to 3.20% [10] , [12] , [13] , [14] , [15] , [16] . The anterolateral and direct anterior approaches have been used in order to minimize dislocation, but the anterolateral approach has been associated with abductor tendon injury and heterotopic ossification and the direct anterior approach has been associated with periprosthetic femur fracture, lateral femoral cutaneous nerve injury, wound complications, and a steep learning curve for the surgeon [17] , [18] , [19] , [20] , [21] , [22] .…”

Section: Introductionmentioning

confidence: 99%

Early results of displaced femoral neck fragility fractures treated with supercapsular percutaneous-assisted total hip arthroplasty

et al. 2019

View full text Add to dashboard Cite

Background Total hip arthroplasty (THA) is the preferred treatment for displaced femoral neck fractures in select patients, although dislocation remains a concern. In some studies, the supercapsular percutaneously assisted (SuperPATH) approach has demonstrated early mobilization, short hospital stay, and low dislocation rates in primary THA, but there are little data on its use for fractures. This study describes the perioperative outcomes and early dislocation rate of SuperPATH THA for displaced femoral neck fragility fractures. Methods A retrospective review was performed of previous ambulatory patients with a displaced femoral neck fragility fracture treated with THA using the SuperPATH approach. Demographic data, time to ambulation, length of stay, and in-hospital complications during the hospital stay and follow-up period were recorded. Phone interviews were conducted to check for dislocations 1 year after surgery. Results Thirty-seven consecutive patients were included with an average age of 75.0 years. Hospital stay averaged 5.5 days, and patients were discharged on average postoperative day 3.6. About 83.8% of patients were ambulatory by postoperative day 1, and 94.6% ambulatory before discharge. Twenty-seven percent of patients were discharged home, 46% to inpatient rehabilitation, 24% to skilled nursing facility, and 1 patient to hospice. At follow-up, there was no symptomatic heterotopic ossification and no infections. Thirty-two patients were available for telephone interviews at 1 year, with no dislocations reported. Conclusions In this small cohort, the SuperPATH approach for THA appears to be safe and effective for use in femoral neck fragility fractures, resulting in early ambulation and a low dislocation rate.

show abstract

“…One of the main reasons could be the posterolateral surgical approach. 24) In addition, according to the literature, thromboprophylaxis with LMWH 4,000 IU per day was continued for 35-40 days and patients managed it autonomously without any bleeding complications. 25) In the literature, there is a wide debate concerning the prevention of a secondary fracture after a fragility fracture.…”

Section: Discussionmentioning

confidence: 99%

Cementless Hemiarthroplasty for Intracapsular Femoral Neck Fractures in the Octa- and Nonagenarians

et al. 2021

View full text Add to dashboard Cite

Backgroud Current evidence supports the use of cemented hemiarthroplasty for treatment of intracapsular femoral neck fractures since it is associated with a lower risk of implant-related complications. However, many medical centers employ the cementless technique for the frail elderly population because it is faster and has lower cardiovascular risks and perioperative mortality. This observational study reports the outcomes of cementless bipolar hemiarthroplasty for intracapsular femoral neck fractures in patients aged 80 years and older. Methods A total of 424 patients (female, 77.1%) with a mean age of 86.9 years were operated for intracapsular femoral neck fractures between January 2009 and December 2017. Of those, 66.7% had an American Society of Anaesthesiologists (ASA) score of 3 or more. All operations were performed with the posterolateral surgical approach and all patients received a cementless stem. Intraoperative and perioperative values and in-hospital outcomes were evaluated, and clinical and radiographical follow-up was done at 40 days, 90 days, and when possible between 5 months and 12 months postoperatively. Multivariate analysis was performed to evaluate if there were factors affecting mortality. Results The mean operative time was 50 minutes. There were no deaths intraoperatively. Intraoperative periprosthetic fractures occurred in 2.1% of the cases with 66.7% of them fixed through cerclage wires intraoperatively. The median length of hospitalization was 11 days (interquartile range, 8.75–15) and 2.4% of patients died while in hospital after surgery. Approximately 91.5% of patients presented with perioperative anemia. Only 1.9% of the complications were related to the implant, 62.5% of which were dislocations. More than 90% of patients were ambulatory either autonomously or with support at each follow-up assessment. Age, male sex, and higher ASA score were related to increased mortality. Conclusions Despite some limitations, this observational study underlines that a cementless femoral stem of modern design can give good clinical outcomes, thus being an appropriate solution especially for the frail elderly.

show abstract

Heterotopic ossification after hemiarthroplasty of the hip – A comparison of three common approaches

Abstract: Our data is the first to evaluate surgical approach and HO in patients with hemiarthroplasty. Patients have a significant risk of developing higher grade HO based on surgical approach (A or AL). Orthopedists should be mindful of these risks when considering A or AL approaches.

Cited by 15 publications

References 27 publications

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

Early results of displaced femoral neck fragility fractures treated with supercapsular percutaneous-assisted total hip arthroplasty

Cementless Hemiarthroplasty for Intracapsular Femoral Neck Fractures in the Octa- and Nonagenarians

Contact Info

Product

Resources

About