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total hip arthroplasty in proximal femoral fracture

Adolph V Lombardi, Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams
INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...
March 12, 2018: Surgical Technology International
Ely L Steinberg, Yaniv Warschawski, Jacob Elis, Dani Rotman, Gil Rachevsky, Shai Factor, Moshe Salai, Tomer Ben-Tov
AIM: Older patients with proximal femoral fractures often undergo preoperative tests due to coexisting morbidities. Our aim was to evaluate these tests and their impact on patient outcome and medical expenses. METHODS: This retrospective study includes data on head computed tomography, carotid ultrasound, echocardiography and pulmonary functional tests calculated according to the type of surgery (osteosynthesis or hip arthroplasty) carried out on 2798 patients. Time-to-surgery, test repeated postoperatively, American Society of Anesthesiology Physical Status score, additional procedures, hospitalization time, 30-day mortality and associated medical expenses were evaluated...
March 7, 2018: Geriatrics & Gerontology International
Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Chao-Ming Chen, Wei-Ming Chen
BACKGROUND: Subsidence remains a common complication after revision hip arthroplasty which may lead to prolonged weight-bearing restrictions, leg-length discrepancies or considerable loss of function. We evaluated the effectiveness of cement augmentation in the proximal femoral metaphysis during a revision of femoral components to prevent post-operative stem subsidence. METHODS: Forty patients were enrolled. Follow-up averaged 67.7 months (range: 24-149). Twenty-seven patients had a Paprosky type II defect and 13 had a type IIIa defect...
February 7, 2018: Journal of the Chinese Medical Association: JCMA
J D Stevenson, V S Kumar, G L Cribb, P Cool
AIMS: Dislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction...
January 2018: Bone & Joint Journal
Moritz M Innmann, Marcus R Streit, Thomas Bruckner, Christian Merle, Tobias Gotterbarm
BACKGROUND: There is a lack of long-term studies into the third decade reporting on the incidence of periprosthetic femoral fracture (PPFF) and aseptic stem loosening (ASL) after cementless total hip arthroplasty (THA). The aim of the present retrospective, longitudinal cohort study was to compare the cumulative incidence of PPFF and ASL in a consecutive cohort of 326 patients with 354 primary uncemented THAs after 20-25 years and to identify risk factors being associated with PPFFs. METHODS: Postoperative femoral fractures were investigated for timing, mechanism of injury, Vancouver classification, and subsequent treatment...
November 16, 2017: Journal of Arthroplasty
Nina M Edwards, Claus Varnum, Per Kjærsgaard-Andersen
INTRODUCTION: The design of the cementless Symax-HA femoral stem is based on geometrical analysis of human femoral anatomy to optimise the fit within the femur. The stem combines an anatomical proximal section enabling a metaphyseal anchorage with a straight distal section. This results in an improved proximal load transfer.We aimed to determine the overall survival of total hip arthroplasty (THA) in patients operated at our institution with the Symax stem. Secondly, we investigated the cause of revision for patients having THA including the Symax stem...
November 23, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
Martin A Buttaro, Pablo A Slullitel, Gerardo Zanotti, Fernando M Comba, Francisco Piccaluga
INTRODUCTION: A wide variety of stems have been used for the treatment of osteoarthritis secondary to advanced hip dysplasia. Since evidence for using short stems in dysplastic hips is limited, we planned to analyse the technical problems encountered when reconstructing the proximal femur of patients with osteoarthritis secondary to congenital dysplasia of the hip treated with total hip arthroplasty (THA) using a type 2B short stem. METHODS: We prospectively analysed 17 patients (22 hips) treated with primary THA performed with a single-branded short uncemented stem with metaphyseal fixation (MiniHip™; Corin)...
October 14, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Terje O Ugland, Glenn Haugeberg, Svein Svenningsen, Stein H Ugland, Øystein H Berg, Are Hugo Pripp, Lars Nordsletten
Background and purpose - The loss of bone mineral in the proximal femur following hip arthroplasty may increase the fracture risk around uncemented stems. We hypothesized that the surgical approach to the hip might influence bone mineral changes around the femoral stem in patients with a femoral neck fracture (FNF). Patients and methods - This was a pre-specified subgroup analysis (n = 51) of an ongoing randomized trial (n = 120) in patients with FNF. Participants were allocated to an uncemented hemiarthroplasty inserted through a direct lateral (Hardinge) approach or an anterolateral (modified Watson-Jones) approach...
February 2018: Acta Orthopaedica
Bertram Rieger, Thomas Ilchmann, Lilianna Bolliger, Karl K Stoffel, Lukas Zwicky, Martin Clauss
INTRODUCTION: During revision total hip arthroplasty (THA), the surgeon commonly faces deficient proximal femoral bone. In this situation, distal fixation of the prosthesis is required. The aim of the current retrospective study is to assess the clinical and radiographic midterm outcome of revision total hip arthroplasty using a modular uncemented, tapered, grit-blasted, distal straight stem system. METHODS: This retrospective study included 70 femoral revisions that were performed in 67 patients using the device of interest...
October 12, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Imran Ilyas, Husam A Alrumaih, Samar Rabbani
BACKGROUND: Avascular necrosis of the femoral head is a well-known sequela of sickle-cell disease (SCD) requiring a surgical intervention that comes with technical challenges. METHODS: Uncemented hip arthroplasty for avascular necrosis of the femoral head due to SCD was carried out for 101 patients (133 hips) between 2000 and 2012. The duration of follow-up ranged from 5 to 17 years (mean, 14.59 years). All patients received a noncemented femoral stem and a noncemented acetabular shell...
September 14, 2017: Journal of Arthroplasty
Afshin Taheriazam, Amin Saeidinia
Purpose of this study was to evaluate the outcomes of patients underwent hemiarthroplasty for proximal femoral fracture converted to total hip arthroplasty (THA).A total of 138 patients from October 2009 till October 2014 had conversion of their failed hemiarthroplasties following a proximal femoral fracture to total hip arthroplasty (THA) in Erfan and Milad hospitals, Tehran. We performed a prospective analysis of the outcome of conversion surgery in patients with failed hemiarthroplasty. The patients had clinical evaluations at 1 month, 6 months, 1 year, and annually thereafter...
October 2017: Medicine (Baltimore)
Ashley A Lloyd, Bernd Gludovatz, Christoph Riedel, Emma A Luengo, Rehan Saiyed, Eric Marty, Dean G Lorich, Joseph M Lane, Robert O Ritchie, Björn Busse, Eve Donnelly
Bisphosphonates are the most widely prescribed pharmacologic treatment for osteoporosis and reduce fracture risk in postmenopausal women by up to 50%. However, in the past decade these drugs have been associated with atypical femoral fractures (AFFs), rare fractures with a transverse, brittle morphology. The unusual fracture morphology suggests that bisphosphonate treatment may impair toughening mechanisms in cortical bone. The objective of this study was to compare the compositional and mechanical properties of bone biopsies from bisphosphonate-treated patients with AFFs to those from patients with typical osteoporotic fractures with and without bisphosphonate treatment...
August 15, 2017: Proceedings of the National Academy of Sciences of the United States of America
Franz Müller, Michael Galler, Tanja Kottmann, Michael Zellner, Christian Bäuml, Bernd Füchtmeier
BACKGROUND: Due to demographic change, more proximal femoral fractures can be expected in the future. However, accurate growth rates as well as follow-up research extending more than 1 year postsurgery are still lacking. MATERIALS AND METHODS: First, we defined inclusion and exclusion criteria for the retrospective cohort study. Based on these, we collected all surgical interventions conducted between 1 January 2006 and 31 December 2015. For a total of 2000 consecutive procedures, we retrieved and analysed a total of 12 variables influencing mortality...
July 24, 2017: Der Unfallchirurg
Matthew T Houdek, Cody C Wyles, Joshua R Labott, Peter S Rose, Michael J Taunton, Franklin H Sim
BACKGROUND: The hip is a common location for metastatic tumors. Due to the high loads placed through the proximal femur, surgery is often indicated to provide pain relief and restore function. Historically, these lesions are reconstructed with a hemiarthroplasty; however, there are few reports on the outcome of these reconstructions. The purpose of this study is to evaluate the outcome of hemiarthroplasty for the treatment of proximal femur metastatic disease, with a specific focus on the rates of conversion to total hip arthroplasty (THA)...
December 2017: Journal of Arthroplasty
Franz Müller, Michael Galler, Michael Zellner, Christian Bäuml, Bernd Füchtmeier
PURPOSE: Total hip arthroplasty (THA) after failed osteosynthesis for proximal femoral fractures is associated with higher revision rates, particularly for dislocation. The purpose of this study was to report our results with THA after failed osteosynthesis within a treatment period of 10 years. METHODS: A retrospective cohort study including 80 consecutive patients was conducted. After a minimum follow-up of 1 year, we evaluated revision for any cause including dislocation, outcome, and mortality...
May 2017: Journal of Orthopaedic Surgery
Andrew N Fleischman, Max M Schubert, Camilo Restrepo, Antonia F Chen, Richard H Rothman
BACKGROUND: Intraoperative fractures during total hip arthroplasty (THA) are more common when using cementless stems. The purpose of this study was to investigate the impact of a new shorter second-generation cementless, tapered wedge stem with improved proximal femoral fit in reducing the incidence of intraoperative fracture. METHODS: A retrospective study was conducted on primary THA cases performed at a single institution using a first-generation or second-generation cementless stem from 2006-2016...
November 2017: Journal of Arthroplasty
Sammy A Hanna, Khaled M Sarraf, Manoj Ramachandran, Pramod Achan
BACKGROUND: Total hip arthroplasty (THA) in patients with sequelae of Legg-Calvé-Perthes disease (LCP) is technically demanding because of the disease related deformities occuring in the proximal femur and/or the multiplanar deformities secondary to corrective osteotomies in childhood. Little is known about the long-term outcome of the procedure in this challenging group of patients. METHODS: We carried out a systematic review of the literature to determine the functional outcome, complications and revision rate of THA in patients with sequelae of LCP disease...
August 2017: Archives of Orthopaedic and Trauma Surgery
Hiroyuki Hatanaka, Goro Motomura, Satoshi Ikemura, Kazuhiko Sonoda, Yusuke Kubo, Takeshi Utsunomiya, Takuaki Yamamoto, Yasuharu Nakashima
INTRODUCTION: The thrust plate hip prosthesis (TPP; Zimmer, Winterthur, Switzerland) is a hip prosthesis that is no longer in production. Few reports have focused on periprosthetic fractures following total hip arthroplasty (THA) with the use of a TPP. PRESENTATION OF CASE: We report a 57-year-old woman with a periprosthetic femoral fracture 13 years after THA with the use of a TPP. A plain radiograph showed a displaced subtrochanteric fracture of the right femur just below the distal tip of the lateral plate without implant loosening...
2017: International Journal of Surgery Case Reports
Song Hong, Jia-Sheng Lin, Yong Zhou, Chang Zou, Wen-Li Zhang, Hong Duan, Chong-Qi Tu
OBJECTIVES: To evaluate the clinical results of femoral proximal fracture with complex hip diseases using an uncemented extensively porous-coated long femoral stems. METHODS: 15 cases of femoral proximal fracture with complex hip diseases treated with the uncemented extensively porous-coated long femoral stem were retrospectively reviewed. All patients were followed up at 1, 3, 6, 12 months in the first year postoperatively and once a year from the second year on...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
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