Metallic versus Non-Metallic Cerclage Cables System in Periprosthetic Hip Fracture Treatment: Single-Institution Experience at a Minimum 1-Year Follow-Up

Abstract

Metallic cerclage cables are reliable and cost-effective internal fixation devices, which are largely used in surgical practice for the treatment of periprosthetic fractures. Nevertheless, complications connected with their use have been described in the literature, including the following: third-body generation, failure and consequent migration, fraying, allergies, and injury to the surgical team. The development of new materials offers alternatives to traditional metallic cables. This study compares the outcomes between two groups of patients affected by periprosthetic hip fractures, treated with titanium cables or with ultra-high-molecular-weight polyethylene (UHMWPe) iso-elastic cables. Our retrospective study aims to compare the clinical and radiological outcomes of titanium cables and UHMWPe iso-elastic cables, isolated or associated with dedicated plates, for the surgical treatment of periprosthetic fractures with stable implants. Two groups of 30 (group A—metallic cables) and 24 (group B—UHMWPe iso-elastic cables) patients have been surgically treated in our institution for hip periprosthetic fractures, between September 2017 and June 2020. The mean age of the patients was 81 years in group A and 80 years in group B. In our study, we included fractures classified as B1 or C, according to the Vancouver postoperative fractures classification; the patients were evaluated retrospectively at 1 year postoperatively, regarding the following: surgery time, blood loss, partial weight-bearing time, radiographical healing time, Harris hip score, and postoperative complications. Comparable outcomes were observed in patients from both groups. Group A showed a higher complication rate compared to group B, at 1 year postoperatively. Non-metallic nylon fiber and ultra-high-molecular-weight polyethylene (UHMWPe) cerclage cables could represent a reliable fixation device, ensuring comparable healing and complication rates with traditional titanium cerclage cables.

In Silico Contact Pressure of Metal-on-Metal Total Hip Implant with Different Materials Subjected to Gait Loading

“…Validation needs to be conducted to determine the accuracy of the computational simulation results obtained from published literature under identical conditions, either analytical, computational, clinical, or experimental. In the current work, we compared the maximum contact pressure of metal-on-metal bearings using CoCrMo with published results of Jamari et al [24] and Hertzian contact (see Equation (2), where F denotes the forces during gait loading, and a is contact radius) [34]. The comparison of maximum contact pressure as validation is described in Figure 4.…”

“…In the field of orthopedics, surgical replacement of diseased human hip joints, such as osteolysis, has been successfully performed using total hip implants [1][2][3]. The use of hardon-soft bearings, such as metal-on-polyethylene and ceramic-on-polyethylene has generally been implanted in the human system through hip replacement surgery.…”

Results of Utilizing Cerclage Wires in the Management of Intraoperative Vancouver B1 Fractures in Primary Total Hip Arthroplasties: A Retrospective Cohort Investigation into Clinical and Radiographic Outcomes

“…Previous investigations have delved into factors correlated to an increased risk of non-union of Vancouver B fractures treated with cerclage wiring, identifying as the most important risk factors associated with the occurrence of this complication patients' age and female gender [15]. Conversely, the type of cerclage employed (metallic vs. iso-elastic cabling) does not seem to entail significant changes in non-union rates at one year; even though metallic wiring might to be associated with a higher risk of failure [16].…”

Minimizing Risk of Failure from Ceramic-on-Ceramic Total Hip Prosthesis by Selecting Ceramic Materials Based on Tresca Stress

“…The use of conventional polyethylene as a coupling material with a hard-on-soft combination, such as metal-on-polyethylene and ceramic-on-polyethylene, has begun to be limited due to the high number of wear cases that affect long-term performance [6]. Additionally, polyethylene wear particles give a negative body response to implant users [7].…”