Revisiting Cemented Femoral Fixation in Hip Arthroplasty

Khanuja, Harpal S.; Mekkawy, Kevin L.; MacMahon, Aoife; McDaniel, Claire; Allen, Dan; Moskal, Joseph T

doi:10.2106/jbjs.21.00853

Cited by 10 publications

(3 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Artificial femoral head replacement is the most effective treatment for femoral neck fractures [2]. Bone cement plays an important role in hemiarthroplasty [3][4][5], but complications, such as cement leakage into the blood vessels reaching the heart, lungs, and cerebral circulation, are common. However, it is exceptionally rare for bone cement to leak into the heart [6,7].…”

Section: Introductionmentioning

confidence: 99%

Intracardiac leakage of cement during artificial femoral head replacement: a case report and review

2024

Int J Clin Exp Pathol

View full text Add to dashboard Cite

Bone cement leakage from the femoral medullary cavity is a rare complication following hip replacement. Currently, there are no reports of bone cement leakage into the heart. Here, we report an 81-year-old female patient with right femoral neck fracture. A thorough preoperative examination showed that bone cement had leaked into the heart during right femoral head replacement, leading to the death of the patient that night. Postoperative cardiac ultrasound showed that bone cement entered the vascular system through the femoral medullary cavity and subsequently entered the heart. Extreme deterioration in the patient's condition resulted in death that night. Unfortunately, the patient's family abandoned the idea of surgical removal of foreign bodies, leading to inevitable death. This case emphasizes the risk of clinical manifestations of cardiac embolism of bone cement after artificial femoral head replacement, suggesting that the risk of such embolism might be underestimated. We propose routine real-time C-arm X-ray guidance and injection of an appropriate amount of bone cement to prevent serious cardiopulmonary failure.

show abstract

Section: Introductionmentioning

confidence: 99%

Intracardiac leakage of cement during artificial femoral head replacement: a case report and review

2024

Int J Clin Exp Pathol

View full text Add to dashboard Cite

show abstract

“…However, in that study 1 , the subsidence of cemented versus uncemented stems in osteoporotic femora was not investigated. Recently, articles which reviewed the outcomes of cemented femoral fixation in hip replacement recommended cemented THA in patients suffering from osteoporosis or having a Dorr type C femur 2,3 . This type is characterized by wide, stovepipe-shaped canal and thin cortices of the proximal femur 4 .…”

Section: Introductionmentioning

confidence: 99%

Cemented and cementless total hip arthroplasty in patients with osteoporosis: an overview

Mystidis,

Chytas,

Kaseta

et al. 2023

JRPMS

View full text Add to dashboard Cite

The purpose of the current review article was to explore to what extent the literature supports cemented or cementless total hip arthroplasty (THA) in osteoporotic patients., in terms of Harris Hip Score, periprosthetic bone loss, periprosthetic fractures, prosthesis subsidence and revision rate. A literature search was performed in PubMed and Cochrane databases to identify articles with purpose to investigate the aforementioned parameters after the use of cemented or cementless THA in patients with osteoporosis or Dorr type C bone, which is typically seen in those patients. Twenty studies were included in the review. Among them, there were two studies which compared cemented with cementless THA in osteoporotic patients and found better outcomes after cemented fixation. The remaining studies investigated only the outcomes of cementless THA in patients with osteoporosis or Dorr type C bone. Most of those studies showed satisfactory outcomes and suggested that cementless THA may not be contraindicated for those patients. The major issue concerning cementless THA was the relatively high rate of periprosthetic fractures. Three studies investigated the use of anti-osteoporotic medication in osteoporotic patients who underwent cementless THA and found positive outcomes. In conclusion, the role of cemented and cementless THA in the case of osteoporosis or Dorr type C bone needs to be further clarified with more comparative studies.

show abstract

“…A recent classification of cemented femoral stem designs was published by Cassar-Gheiti et al in 2020 and is illustrated in Figure 1 of their work; however, this classification does not account for newer designs such as anatomic taper-slip designs or line-to-line triple-taper designs, nor does it distinguish between collared and collarless protheses. 4,5 The purpose of this review was to (1) describe the overarching principles of cemented femoral stem designs currently used, including the biomechanical basis for their development, and (2) propose an updated classification system for cemented femoral stem designs that incorporates key design characteristics.…”

mentioning

confidence: 99%

Cemented Stem Design in Total Hip Arthroplasty: Fixation Philosophies, Biomechanics, and an Updated Classification System

Hegde,

Harris,

Springer

et al. 2024

J Am Acad Orthop Surg

Self Cite

View full text Add to dashboard Cite

There is renewed interest in cemented femoral fixation in total hip arthroplasty in the United States, and to fully appreciate the evolution of cemented femoral stem designs, an understanding of their history and design rationale is essential. To adequately study the outcomes of modern-day designs, a comprehensive classification system is also necessary. The biomechanical principles, failure mechanisms, and clinical outcomes associated with various cemented femoral stems are described in this comprehensive review. In addition, an updated version of an existing classification system is described that incorporates the primary design characteristics which differentiate implants currently in use. In this classification, implants are categorized as taper-slip (Type I), which are subdivided by Anatomic (IA), Double-Taper (IB), and Triple-Taper (IC) with subclassification for Traditional and Line-to-Line implants. Composite beam (Type II) implants are similarly divided into Anatomic (IIA), Straight (IIB), and Wedge (IIC) with subclassification for Polished, Satin, or Roughened finish. This classification system provides a basis for comparing cemented femoral stems, thereby improving our understanding of the effect of design characteristics on survivorship to guide future advancements and improve clinical outcomes.

show abstract

Revisiting Cemented Femoral Fixation in Hip Arthroplasty

Cited by 10 publications

References 66 publications

Intracardiac leakage of cement during artificial femoral head replacement: a case report and review

Intracardiac leakage of cement during artificial femoral head replacement: a case report and review

Cemented and cementless total hip arthroplasty in patients with osteoporosis: an overview

Cemented Stem Design in Total Hip Arthroplasty: Fixation Philosophies, Biomechanics, and an Updated Classification System

Contact Info

Product

Resources

About