Incidence, Classification, and Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients Undergoing Total Hip Arthroplasty With a Single Stem: A Retrospective Study

Liu, Bo; Ma, Wenhui; Li, Huijie; Wu, Tao; Han, Yongtai

doi:10.1016/j.arth.2019.03.031

Cited by 39 publications

(53 citation statements)

References 27 publications

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“…19,20 Several articles reveal the importance of BMD for treatment with uncemented collarless stem. 21,22 When inserting an uncemented femoral stem slightly larger than the prepared femoral canal, operation procedure can produce compression hoop stress. Lower bone density and different morphology can lead to different results.…”

Section: Discussionmentioning

confidence: 99%

Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type

Song

Lee

et al. 2019

J Orthop Surg (Hong Kong)

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Background: Hydroxyapatite (HA)-coated stem has been introduced to decrease complications and eventually achieve quicker implant ingrowth and long-term stability. The aim of this study was to determine subsidence rate and incidence of perioperative periprosthetic fracture (PPF) of uncemented collarless Corail stem for displaced femoral neck fractures according to Dorr type. Methods: A retrospective review of plain radiographs and clinical data was carried out to identify consecutive patients who underwent uncemented hip hemiarthroplasty using collarless HA-coated Corail stem between March 2010 and August 2014. The risk of subsidence and PPF according to Dorr type was evaluated. Results: Dorr types A, B, and C were found in 66 (median age 74, 29.7%), 107 (median age 77, 48.2%), and 49 (median age 80, 22.1%) cases, respectively. Subsidence of stem occurred in eight (3.6%) cases. Dorr type had significant relationship ( p < 0.05) with subsidence. Type C canals had higher rates of subsidence. PPFs occurred in 11 (5.0%) cases without showing significant difference among Dorr types not significant (n.s.). Female gender was not influential on subsidence (n.s.) and PPF (n.s.). Conclusion: Dorr type C had higher risk of subsidence when using uncemented collarless HA-coated stem. Dorr canal type had no bearing on risk of PPFs. Women did not have significantly higher risk of both subsidence and PPFs compared to men. A collarless fully HA-coated Corail stem had 3.6% of radiological subsidence and 5.0% of PPF risk.

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Section: Discussionmentioning

confidence: 99%

Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type

Song

Lee

et al. 2019

J Orthop Surg (Hong Kong)

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“…[80,81] However, the present study demonstrated an incidence of 1.4%, which is lower than the 2.95-10.6% reported in other large series. [82][83][84][85] The three intraoperative fractures in the present series were all treated successfully using cerclage cables inserted through a smaller secondary incision without compromising the short external rotators. The only other complication attributable to decreased visualization was a return to the OR from PACU after a postoperative radiograph demonstrated a previously unrecognized piece of bone interposed between the prosthetic head and cup.…”

Section: Discussionmentioning

confidence: 73%

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Kay¹,

Klavas²,

Haghshenas³

et al. 2020

Preprint

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BACKGROUNDDislocation after primary total hip arthroplasty (THA) has an incidence of 2-3. Approximately 77% of dislocations occur within the first year after surgery. The SuperPATH technique is a minimally invasive approach for THA that preserves soft tissue attachments. The purpose of this study is to describe the dislocation rate at one year after SuperPATH primary THA. METHODSAll elective primary THAs performed by the senior author using the SuperPATH approach. Exclusion criteria were acute femoral neck fracture, revision surgery, or malignancy. There were 214 of 279 eligible patients available for telephone interviews (76.7%). Medical records were reviewed for secondary outcomes including early and late complications, cup positioning, distance ambulated on postoperative day one, discharge destination, and blood transfusions. RESULTSMean age at surgery was 64 ± 10.8 years and mean time to telephone follow up was 773 ± 269.7 days. There were 104 female and 110 male patients. There were zero dislocations reported. Blood transfusions were performed in 3.7% of patients, and 75.7% were discharged to home at an average of 2.3 ± 1.0 days. Cup position averaged 43.6 ± 5.2° abduction and 20.9 ± 6.2° anteversion, with an average leg length discrepancy of 3.6 ± 3.32mm. Complications included three intraoperative calcar fractures, one periprosthetic femur fracture, one early femoral revision, three superficial infections, and one instance of wound necrosis.CONCLUSIONSuperPATH approach is safe for use in primary THA resulting in a low dislocation rate.

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“…Panula et al [25] reported that periprosthetic fractures were associated with increased risk of revision for dislocation after total hip arthroplasty. Devane et a [26] and Liu et al [27] also reported that intraoperative periprosthetic femoral fractures were commonly accompanied with poor clinical outcomes of patients. In this study, the femoral component was characterized as metaphyseal xation and distal end polishing design.…”

Section: Discussionmentioning

confidence: 99%

Short Uncemented Femoral Component for Hip Revision: Prognosis and Risk Factors Associated With Failure

Liu

Zhang

et al. 2020

Preprint

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BackgroundThe application of short uncemented femoral stem is partially restricted in revision surgery. In some patients with mild to moderate bone deficiency, short uncemented stem is certainly a choice. This study will demonstrate the therapeutic effect and unsuitable situation for short uncemented stem revision.MethodsPatients who undergone hip revision from January 2005 to December 2015 were retrospectively analyzed in this study. Preoperative radiological images were evaluated to help estimating the bone deficiency around hip joint. Mann-Whitney U test was performed for comparison between continuous variables. Chi-square test was performed for comparison between categorical variables. Cox regression analysis was used to assess the association between potential risk factors and failure of revision surgery.ResultsA total of 381 patients were retrospectively reviewed. The mean follow-up time was 71.05±16.54 months. The mean time from primary revision surgery to secondary revision surgery was 16.41±17.47 months. According to the survival status of femoral component at final follow-up, patients were divided into two groups. Cox regression analysis revealed that the risk for revision failure approximately increased by 5.6% for every year of age increase (HR=1.056, 95%CI=1.012–1.102). Osteoporosis was another independent risk factor for revision failure (HR=2.802, 95%CI=1.097–7.157). The strongest risk factor was intraoperative periprosthetic femoral fracture during revision surgery in this study (HR=5.477, 95%CI=2.156–13.913).ConclusionThree risk factors for failure are identified, such as aging, osteoporosis and intraoperative periprosthetic femoral fracture during revision surgery. Therefore, short uncemented femoral stem should be implanted in these patients with additional caution.

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Incidence, Classification, and Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients Undergoing Total Hip Arthroplasty With a Single Stem: A Retrospective Study

Cited by 39 publications

References 27 publications

Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type

Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Short Uncemented Femoral Component for Hip Revision: Prognosis and Risk Factors Associated With Failure

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