Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CL®)

Tootsi, Kaspar; Lees, Loviisa; Geiko, Boris; Märtson, Aare

doi:10.1186/s10195-020-00548-6

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…Final decision whether to use DAA was made by the orthopaedic surgeon, in compliance with the exclusion criteria, operating based on age, fragility, bone morphology, and level of activity of the patient. In a same way, decision whether implant straight or anatomical stem was made by orthopaedic surgeon in compliance with proximal femoral anatomy after pre-operative planning[ 20 , 21 ]. Ceramic on ceramic coupling was chosen and 32 mm or 36 mm head diameter were used in all cases.…”

Section: Methodsmentioning

confidence: 99%

Direct anterior approach hip arthroplasty: How to reduce complications - A 10-years single center experience and literature review

Rivera¹,

Comba²,

Bardelli³

2022

WJO

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BACKGROUND The direct anterior approach for total hip arthroplasty (DAA-THA) is increasing in popularity due to some advantages such as less surgical trauma, minimal dissection of soft tissues, shorter rehabilitation times, faster return to daily activities, lower incidence of dislocation. On the other hand, the literature reports a high rate of intraoperative complications, with many different rates and complication types in the published papers. AIM To analyze our complications comparing results with the literature; to report measures that we have taken to reduce complications rate. METHODS All DAA-THA patients with one year minimum follow up who were operated at a single high-volume centre, between January 2010 and December 2019 were included in this retrospective study. All surgeries were performed using cementless short anatomical or straight stems and press fit cups. Patients’ follow-up was performed, at 6 wk, 3 mo, then annually post-surgery with clinical and radiological evaluation. Primary outcomes were stem revision for aseptic loosening and all-cause stem revision. Second outcome was intra-operative and post-operative complications identification. RESULTS A total of 394 patients underwent DDA-THA from January 2010 and December 2019, for a total of 412 hips; twelve patients lost to follow-up and one patient who died from causes not related to surgery were excluded from the study. The average age at the time of surgery was 61 years (range from 28 to 78 years). Mean follow-up time was 64.8 mo (range 12-120 mo). Seven stems were revised. One cortical perforation, one trochanteric and lateral cortical wall intraoperative fracture, one diaphyseal fracture, three clinically symptomatic early subsidence and one late aseptic loosening. We also observed 3 periprosthetic fractures B1 according to the Vancouver Classification. Other minor complications not requiring stem revision were 5 un-displaced fractures of the calcar region treated with preventive cerclage, one early infection, one case of late posterior dislocation, 18 case of asymptomatic stem subsidence, 6 cases of lateral cutaneous femoral nerve dysesthesia. CONCLUSION DAA is associated to good outcomes and lower incidence of dislocation. Complication rate can be reduced by mindful patient selection, thorough preoperative planning, sufficient learning curve and use of intraoperative imaging.

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Section: Methodsmentioning

confidence: 99%

Direct anterior approach hip arthroplasty: How to reduce complications - A 10-years single center experience and literature review

Rivera¹,

Comba²,

Bardelli³

2022

WJO

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“…Currently, total hip arthroplasty (THA), which serves as an effective treatment for patients with hip pain and dysfunction, has been lauded as “the operation of the century” by The Lancet ; 1 by 2030, only in the United States would the demand for THA increase by 174% from 2005 to 572,000 2 . However, its various complications, which result in a high risk of revision surgery and are accompanied by high morbidity rates, are still problems to be studied 3–5 . Fractures account for a large proportion of complications during THA and may cause infection and atrophic nonunion 6,7 .…”

Section: Introductionmentioning

confidence: 99%

“… 2 However, its various complications, which result in a high risk of revision surgery and are accompanied by high morbidity rates, are still problems to be studied. 3 , 4 , 5 Fractures account for a large proportion of complications during THA and may cause infection and atrophic nonunion. 6 , 7 As one of the complications of THA, periprosthetic femoral fractures (PFFs) have been reported to have an increasing incidence in recent years, probably due to previous revision arthroplasty surgeries, and the presence of rheumatoid arthritis.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Characteristics of the Femoral Isthmus during Total Hip Arthroplasty in Patients with Adult Osteoporosis and Developmental Dysplasia of the Hip: A Finite Element Analysis

Sun

Zhang

Liu

et al. 2022

Orthopaedic Surgery

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Objective This study investigated the underlying mechanisms of high fracture incidence in the femoral isthmus from a biomechanical perspective. Methods We retrospectively analyzed a total of 923 primary total hip arthroplasty (THA) patients and 355 osteoporosis (OP) patients admitted from January 2010 to January 2018. Through a series of screening conditions, 47 patients from each group were selected for inclusion in the study. The datasets on the unaffected side and affected side of the patients with unilateral developmental dysplasia of the hip (uDDH) were respectively classified as the normal group (Group I) and he tDDH group (Group II), and that of patients with osteoporosis were classified as the OP group (Group III). In this study, first, we collected computed tomography (CT) images and measured geometric parameters (inner and outer diameters) of the isthmus. Thereafter, to study biomechanical properties, we established six finite element models and calculated values of von Mises stress for each group with the methods of data conversion and grid processing. Results Compared with those of patients in the normal group, the values of the inner and outer diameters of femoral isthmus of patients in the DDH group were significantly lower (P < 0.001), while the inner diameters of patients in the OP group were significantly higher (P < 0.001) and the outer diameters of patients in the OP group showed no significant difference (P> 0.05). The cortical rates of patients in the normal group and the DDH group appeared insignificant (P > 0.05), and those of patients in normal group were significantly higher than those of patients in the OP group (P < 0.001). Moreover, patients in the DDH group showed a higher von Mises stress value than patients in the normal group (P < 0.001), but statistically speaking the values between patients in the OP and normal groups were insignificant (P > 0.05). Conclusions The relatively shorter inner and outer diameters of the isthmus in DDH resulted in intensive von Mises stress under the torque of the hip location, and induced a high fracture incidence. However, in patients in the OP group, the geometric morphology exhibited no anatomical variation, and the fracture was not due to the intensity of von Mises stress.

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“…In the case of periprosthetic fractures, periprosthetic acetabular fractures are less common than periprosthetic femoral fractures [ 5 – 8 ]. However, complications around the acetabular component can have serious consequences in such patients.…”

Section: Introductionmentioning

confidence: 99%

Multi-Site Insufficiency Pelvic Fracture Following Total Hip Arthroplasty

et al. 2020

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Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CL®)

Cited by 8 publications

References 27 publications

Direct anterior approach hip arthroplasty: How to reduce complications - A 10-years single center experience and literature review

Direct anterior approach hip arthroplasty: How to reduce complications - A 10-years single center experience and literature review

Biomechanical Characteristics of the Femoral Isthmus during Total Hip Arthroplasty in Patients with Adult Osteoporosis and Developmental Dysplasia of the Hip: A Finite Element Analysis

Multi-Site Insufficiency Pelvic Fracture Following Total Hip Arthroplasty

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