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Periprosthetic AND Fracture

Jie-Feng Huang, Xian-Jun Jiang, Jian-Jian Shen, Ying Zhong, Pei-Jian Tong, Xiao-Hong Fan
BACKGROUND: The Unified Classification System (UCS) for Periprosthetic femoral fractures (PPFF) still has some limitations. METHODS: We retrieved 18 previous classifications for PPFF based on systematic review of the literature, and also retrospectively analyzed 402 cases with PPFF. 46 cases (11.4%) were identified as beyond the classification scope of the original UCS. RESULTS: We modified the UCS as follows: (1) add two new B2 subtypes: B2PALT/B2PAGT (i...
August 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Dietmar Dammerer, David Putzer, Bernhard Glodny, Johannes Petersen, Ferdi Arrich, Martin Krismer, Rainer Biedermann
PURPOSE: Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication. METHODS: Between 2003 and 2012, a total of 3390 cementless total hip arthroplasties (THA) were performed at our institution. Their medical histories were retrospectively reviewed to identify all patients who received a thin-layer computer tomography (CT) scan of the pelvis including the acetabulum within the first 30 post-operative days...
August 10, 2018: International Orthopaedics
Hong-Man Cho, Jae-Woong Seo, Hyun-Ju Lee, Kyu-Bok Kang, Jung-Ryul Kim, Ho-Wook Wee
OBJECTIVE: There is limited literature concerning the outcomes and role of THA as a surgical option for amputee patients. The aim of this study is to determine the mid-to long-term survival and complication rates of cementless total hip arthroplasty (THA) in patients with contralateral below knee amputations. METHODS: A retrospective review of 54 patients with below knee amputation were perfomed who underwent THA for osteoarthritis of the contralateral hip over a 5-year period between 1999 and 2014...
August 7, 2018: Acta Orthopaedica et Traumatologica Turcica
Arash Aali-Rezaie, Pouya Alijanipour, Noam Shohat, Hamed Vahedi, Carol Foltz, Javad Parvizi
BACKGROUND: Revision total joint arthroplasties (TJAs) have been empirically associated with significant postoperative morbidity and mortality. Red blood cell distribution width (RDW), a frequently measured hematological parameter, has been shown to predict mortality in hip fracture patients. However, its utility in risk-stratifying patients before revision TJA remains unknown. The aim of this study was to investigate the possible relationship between preoperative RDW levels and outcome of revision arthroplasty in terms of mortality, adverse outcomes, and length of hospital stay...
July 4, 2018: Journal of Arthroplasty
B Barenius, C Inngul, Z Alagic, A Enocson
Aims: The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods: A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58)...
August 2018: Bone & Joint Journal
R W Westerman, S L Whitehouse, M J W Hubble, A J Timperley, J R Howell, M J Wilson
Aims: The aim of this study was to report the initial results of the Exeter V40 stem, which became available in 2000. Patients and Methods: A total of 540 total hip arthroplasties (THAs) were performed in our unit using this stem between December 2000 and May 2002. Our routine protocol is to review patients postoperatively and at one, five, and ten years following surgery. Results: A total of 145 patients (26.9%) died before ten years and of the remaining 395 stems, 374 (94...
August 2018: Bone & Joint Journal
Pablo Ariel Slullitel, Jose Ignacio Oñativia, Lionel Llano, Fernando Comba, Gerardo Zanotti, Francisco Piccaluga, Martin Alejandro Buttaro
Despite the theoretical advantages of uncemented short stems, postoperative thigh pain is still matter of concern and can be attributed to different causes. We report a peculiar case of a stress fracture around a short cementless stem with cervico-metaphyseal fixation in an otherwise healthy patient. We implanted a MiniHipTM stem in a 43 year-old male professional golf player for the treatment of primary osteoarthritis using a ceramic on ceramic bearing. Against medical advice, the patient started to play soccer at the 4th postoperative month and was completely asymptomatic to that extent; but at 8 months follow-up and without a history of trauma he started complaining about progressive hip pain...
2018: SICOT-J
Cristiana Forni, Domenica Gazineo, Fabio D'Alessandro, Ambra Fiorani, Mattia Morri, Tania Sabattini, Elisa Ambrosi, Paolo Chiari
PURPOSE: The study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors. METHODS: A prospective multicentric study was performed. All patients aged ≥ 65 years, with fragility hip fractures, consecutively admitted in two Italian hospitals were included. Patients with periprosthetic or pathological fractures were excluded. Logistic regression was used to identify patient and patient care variables that independently influenced the 30-day mortality and receiver operating characteristic (ROC) curve analysis to assess their predictive capacity on the outcome...
July 27, 2018: International Orthopaedics
Anoop Prasad, Richard Donovan, Manoj Ramachandran, Sebastian Dawson-Bowling, Steven Millington, Rej Bhumbra, Pramod Achan, Sammy A Hanna
Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients...
June 2018: EFORT Open Reviews
Jakub Zeman, Matúš Ranuša, Martin Vrbka, Jiří Gallo, Ivan Křupka, Martin Hartl
Ultra-high molecular polyethylene (UHMWPE) is one of the most used materials of the acetabular liners in total tip arthroplasty (THA). Polyethylene has good tribological properties and biocompatibility. However, the lifetime of polyethylene implants is limited by wear related complications. Polyethylene material released into the periprosthetic environment induces osteolysis that can be followed by implant loosening. Wear of cup is influenced mainly by orientation of the cup in pelvis, by initial geometry before the material degradation and by tribological parameters...
July 12, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Toby Jennison, Rathan Yarlagadda
Periprosthetic fractures of the proximal femur after hip hemiarthroplasty are an increasing concern. The aim of this study was to analyse the 30 day mortality of periprosthetic fractures around a hip hemiarthroplasty. A retrospective case review at a single institution. 32 patients. Mean age 76.5, 16 males and 16 females. 13% underwent non-operative treatment, 50% open reduction internal fixation and 38% revision arthroplasty. 30 day mortality was 12.5% and 1 year mortality 28.1%. Time to surgery was the only significant risk factor for 30 day mortality Periprosthetic fractures following a hip hemiarthroplasty have high 30 day mortality...
September 2018: Journal of Orthopaedics
Jane Liu, Nicholas B Frisch, Nima Mehran, Mossub Qatu, S Trent Guthrie
The purpose of this retrospective cohort study was to evaluate whether there is an increased rate of short-term medical complications following short vs long cephalomedullary nails for the treatment of intertrochanteric hip fractures. A total of 899 patients treated surgically with cephalomedullary nails from January 1, 2005, to September 1, 2014, were included. Patients who received short nails (n=334) were older and had a higher incidence of coronary artery disease and diabetes mellitus compared with patients who received long nails (n=565)...
July 16, 2018: Orthopedics
Georgios Chatziagorou, Hans Lindahl, Göran Garellick, Johan Kärrholm
INTRODUCTION: Periprosthetic femoral fractures (PPFF), treated surgically, have been recorded in the Swedish Hip Arthroplasty Register (SHAR) since 1979. It is postulated that fractures treated with other methods other than stem revision have a lower registration rate, which may lead to incomplete registry data and thus, inaccurate information. We collected all PPFFs surgically treated in Sweden between 2001 and 2011 with the purpose of studying the annual incidence, demographics and distribution of fracture types with regard to type of fixation...
July 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Seth R Yarboro
In this case, a lateral locking plate is used for fixation of a periprosthetic distal femur fracture in a 68-year-old woman. Modern implants with locking screw options and soft-tissue-sparing surgical techniques have improved the care of periprosthetic distal femur fractures. Although much debate about the working length and technical variables of plating exists, it is generally accepted that longer (>10 hole) plates with adequate working length and careful soft-tissue handling are preferred. This case outlines a stepwise approach to distal femur fractures to achieve appropriate plate position and restoration of alignment while avoiding excessive surgical exposure or soft-tissue dissection...
August 2018: Journal of Orthopaedic Trauma
Salduz Ahmet, Kılıçoğlu Önder İsmet, Ekinci Mehmet, Yıldız Eren, Tözün Remzi, Yazıcıoğlu Önder
INTRODUCTION: The aim of this study was to analyze the survival of the Echelon® femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. PATIENTS AND METHODS: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78...
May 2018: Journal of Orthopaedic Surgery
Fernando Y Zapata-Cornelio, Zhongmin Jin, David C Barton, Alison C Jones, Ruth K Wilcox
Long bone fractures are common and although treatments are highly effective in most cases, it is challenging to achieve successful repair for groups such as open and periprosthetic fractures. Previous biomechanical studies of fracture repair, including computer and experimental models, have simplified the fracture with a flat geometry or a gap, and there is a need for a more accurate fracture representation to mimic the situation in-vivo . The aims of this study were to develop a methodology for generating repeatable transverse fractures in long bones in-vitro and to characterise the fracture surface using non-invasive computer tomography (CT) methods...
June 2018: Bone Reports
Sebastian Lotzien, Clemens Hoberg, Martin F Hoffmann, Thomas A Schildhauer
PURPOSE: The number of total knee arthroplasties (TKA) increased rapidly. In conjunction with higher implantation rates, periprosthetic femur fractures following TKA are also gradually increasing. Purpose of this study was to evaluate polyaxial locking plate treatment of periprosthetic femoral fractures with retained total knee replacement using polyaxial locking plates in regard to quality of life, functional outcome and complications. METHODS: The Study design is a single-center retrospective cohort analysis...
June 22, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Andrew H Schmidt
Periprosthetic fractures are typically defined as fractures occurring adjacent to a total joint arthroplasty. However, fractures may occur adjacent to a previous internal fixation device used to treat a prior fracture in the same patient, or between implants (the interprosthetic fracture). All of these injuries tend to occur in frail patients with severe osteopenia, and therefore are very challenging to treat. This article provides a brief but thorough review of the current state of the art regarding the treatment of these challenging problems...
June 2018: Injury
Stefano Biggi, Andrea Camera, Riccardo Tedino, Andrea Capuzzo, Stefano Tornago
PURPOSE: To retrospectively review results and complications of our standardized surgical technique addressed exclusively to Vancouver B2 fractures. METHODS: From January 2006 to July 2016, we treated 235 consecutive patients, 47 males and 188 females, mean age at surgery of 71 ± 10 years, with periprosthetic B2 fractures. Exclusion criteria were other kind of periprosthetic fractures and other femoral fractures. The patients were assessed clinically and radiographically following our standard protocol at the last available follow-up...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
M N Baig, Abdul Halim Dzufar, Colin G Murphy, Bill Curtin
Lateral femoral prosthesis perforation is an uncommon periprosthetic fracture. Periprosthetic fractures may be fixed with open reduction and internal fixation, or with revision arthroplasty, depending on the type of fracture, the condition of the host bone in the proximal femur, the stability of the implant, and occasionally the medical co-morbidities of the patient. Proximal femoral replacement is a complex and challenging procedure but provides a better chance of early mobilisation. We describe a case of treating a 71-year-old woman who presented with an unusual type of periprosthetic fracture, treated with a revision arthroplasty procedure using a proximal femur replacement...
April 17, 2018: Curēus
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