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Periprosthetic femoral fractures

Elke Jeschke, Mustafa Citak, Christian Günster, Andreas M Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz U Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: The aim of our study is to evaluate the association of body mass index (BMI) and the risk of postoperative complications, mortality, and revision rates following primary total hip arthroplasty given other potentially confounding patient characteristics in a large cohort study. METHODS: Using nationwide billing data for inpatient hospital treatment of the biggest German healthcare insurance, 131,576 total hip arthroplasties in 124,368 patients between January 2012 and December 2014 were included...
February 17, 2018: Journal of Arthroplasty
Agraharam Devendra, M Avinash, Dinesh Chidambaram, Jayaramaraju Dheenadhayalan, S Rajasekaran
PURPOSE: The cerclage passer instrument was introduced for aiding percutaneous reduction in spiral femur fractures, thereby overcoming the risk of devascularization of the fracture ends commonly associated with traditional open cerclage wiring techniques. This may, however, predispose to iatrogenic vascular injuries owing to the proximity of the vessels and several other factors. We report four cases with femoral artery (superficial and deep) injuries caused by the cerclage passer in proximal femur and distal femur shaft fractures and incidence of these injuries in our institution...
January 2018: Journal of Orthopaedic Surgery
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
Chi Zhang, Bo Xu, Guanzhao Liang, Xianshang Zeng, Dan Zeng, Deng Chen, Zhe Ge, Weiguang Yu, Xinchao Zhang
Objectives To compare the functional and radiographic outcomes of InterTAN nail (IT) and proximal femoral nail anti-rotation (PFNA) for managing primary AO/OTA 31-A2 intertrochanteric hip fractures (IHFs) in older osteoporotic patients. Methods Patients aged 60 years or older who received surgical treatment for IHFs (AO/OTA 3.1A2.1-A2.3) with IT or PFNA were retrospectively evaluated. The primary outcome was the postoperative treatment failure rate. The secondary outcome was the Harris Hip Score (HHS). Results A total of 326 osteoporotic cases (326 hips: IT, n = 162; PFNA, n = 164) were assessed with a mean follow-up of 43...
January 1, 2018: Journal of International Medical Research
Philippe Hernigou, Jean Charles Auregan, Claire Bastard, Victor Housset, Charles Henri Flouzat-Lachaniette, Arnaud Dubory
PURPOSE: It is unclear whether late THA periprosthetic femoral fractures are related to a mechanical mechanism that decreases strength of the femur (for example, loosening) or to a biological problem as osteolysis. It is also unknown if ceramic on ceramic bearing couples decrease the risk of late periprosthetic fractures as a result of the absence of wear and osteolysis. MATERIAL AND METHODS: We therefore asked whether the cumulative long-term fractures were different according to the couple of friction ceramic on ceramic or ceramic on polyethylene in 327 patients (654 hips) with bilateral THA (one ceramic-ceramic, and the contralateral ceramic-polyethylene) who had THA with cemented stems performed between from 1978 to 2000 for osteonecrosis...
March 4, 2018: International Orthopaedics
Nikola Bulatović, Miroslav Kezunović, Čedomir Vučetić, Nermin Abdić, Ivan Benčić, Tomislav Čengić
The rate of periprosthetic femoral fractures following total hip replacement has been growing steadily in the last 20 years and ranges from 0.1% to 2.1%. These fractures are mostly related to older patients with the presence of chronic diseases and frequently poor bone quality. The treatment is surgically very complex and demanding, followed by a series of complications. The evaluation in this retrospective study included 23 patients who were medically treated from January 2004 to December 2015 with the mean follow-up of 14...
September 2017: Acta Clinica Croatica
S Cohen, X Flecher, S Parratte, M Ollivier, J N Argenson
INTRODUCTION: The incidence of periprosthetic femoral fracture is constantly increasing, with high associated morbidity and mortality. Surgical treatment is guided by the Vancouver classification, but the influence of type of treatment on morbidity and mortality has been little analyzed. The theoretic advantage of implant revision over internal fixation is that it should allow earlier weight-bearing, although the impact of this on morbidity and mortality and autonomy has not been demonstrated...
February 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Marc R Angerame, Thomas K Fehring, John L Masonis, J Bohannon Mason, Susan M Odum, Bryan D Springer
BACKGROUND: In an era of innovation in surgical approaches for total hip arthroplasty (THA), there is concern for increasing trends of early failure. The purpose of this study is to evaluate the incidence of early failure of primary THA stratified by surgical approach. METHODS: A retrospective review was performed on consecutive primary THAs completed from 2007 to 2014 at a high-volume center. THAs were stratified by surgical approach. Only the direct anterior (DAA) and posterior approaches (PA) were included...
February 2, 2018: Journal of Arthroplasty
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
Jarrad Stevens, Nicholas Clement, Michael Nasserallah, Michael Millar, Sam Joseph
INTRODUCTION: Periprosthetic fractures of the proximal femur place a significant burden on the patients who endure them, as well as the medical health system that supports them. The purpose of this study was to determine whether femoral cortical thickness, as an absolute measurement, is a predictor of periprosthetic fracture pattern. METHOD: A cohort of 102 patients who had sustained a periprosthetic hip fracture were retrospectively identified. This included 58 males and 44 females with a mean age of 79...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
M Ehlinger, L Niglis, H Favreau, S Kuntz, G Bierry, P Adam, F Bonnomet
Cerclage wire is an effective fracture fixation method. However, its mechanical benefits are countered by local ischemia. Its efficacy for treating femoral periprosthetic fractures has been demonstrated since femoral fixation is possible even there is a stem in the diaphysis. It securely holds the proximal femur typically with an additional plate. The development of minimally-invasive surgery with plate fixation has led to the cerclage wire being inserted percutaneously.Here, we report on a case of secondary femoral ischemia following percutaneous cerclage wire of a periprosthetic femoral fracture...
February 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
T Jennison, R Yarlagadda
BACKGROUND: Mortality rates following hip fractures are decreasing. As these outcomes improve, it increases the potential for further falls and the potential to sustain a periprosthetic fracture. The aim of this study was to analyse the 1 year mortality of periprosthetic fractures around an implant used to treat an extracapsular hip fracture. Secondary outcomes included 30 day mortality, complications and risk factors associated with mortality. METHODS: A retrospective case note and radiographic review of all patients who presented to a single institution with a periprosthetic femoral fracture around an implant previously used to treat an extracapsular hip fracture between 1st January and 2008 and 31st May 2015...
January 2, 2018: Injury
Bo Shi, Ming-Rui Xie, Zong-Yuan Li
OBJECTIVE: To evaluate the efficacy of capsular-enhanced repair with suture anchors in bipolar hemiarthroplasty for the treatment of femoral neck fractures in elderly patients. METHODS: A retrospective study was designed. From June 2009 to June 2016, 53 senile patients (54 hips)with femoral neck fracture were treated operatively in Mianyang central hospital (Sichuan, China). There were 21 males and 32 females, ranging in age from 80 to 97.5 years old (mean, 84.7 years old)...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Xian-Wu Chen, Ru-Qing Ye, Hai-Ping Xu
OBJECTIVE: To retrospectively study the clinical results of total hip arthroplasty(THA) using Wagner SL revision stem for patients with femoral intertrochanteric fracture. METHODS: From 2006 January to 2009 December, 29 consecutive patients with femoral intertrochanteric fractures were performed THA using Wagner SL revision stem and intertrochanteric reconstruction, including 18 males and 11 females with an average age of 49 years old ranging from 43 to 58. Among them, 8 cases were oboslete femoral intertrochanteric fractures and 21 cases were the intertrochanteric fractures with painful arthritis before injuries...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Dirk Zajonz, Alexander Brand, Christian Lycke, Orkun Özkurtul, Jan Theopold, Ulrich J A Spiegl, Andreas Roth, Christoph Josten, Johannes K M Fakler
PURPOSE: Periprosthetic joint infections (PJI) after hemiarthroplasty for geriatric femoral neck fractures are a devastating complication that results in serious morbidity and increased mortality. Identifying risk factors associated with early infection after HA for hip fractures may offer an opportunity to address and prevent this complication in many patients. The aim of this study was to evaluate preoperative risk factors for early PJI after HA in hip fracture patients. METHODS: From January 2010 to December 2015, 312 femoral neck fractures (AO/OTA 31-B) in 305 patients were included in this single-center, retrospective study...
January 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
INTRODUCTION: The Taperloc® Complete femoral stem (Zimmer Biomet, Warsaw, Indiana) builds on the widespread clinical success of the original Taperloc design used since 1982. Enhancements to the Complete design include a lowered caput-collum-diaphyseal (CCD) angle from 138° to 133° for improved offset, optimized neck taper with polished neck flats to increase range of motion, reduced distal geometry to improve proximal canal fill, and gradual off-loading that is the goal of tapered geometry...
December 22, 2017: Surgical Technology International
Hakan Çiçek, Ümit Tuhanioğlu, Hasan Ulaş Oğur, Fırat Seyfettinoğlu, Murat Bozkurt
INTRODUCTION: Patients with Su Type III fractures based on total knee arthroplasty (TKA) constitute a patient group with problematic treatment and management. Although it has difficulties, open reduction and internal fixation is one of the treatment options. METHOD: A retrospective evaluation was made of 22 patients surgically treated in our clinic with double locking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. The patients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS), WOMAC and radiological evaluations...
January 3, 2018: Acta Orthopaedica et Traumatologica Turcica
Hasmukh Nagwadia, Prateek Joshi
INTRODUCTION: Incidence of periprosthetic fractures around knee is going to rise in near future due to dramatic increase in total knee arthroplasty (TKA). Our study is a retrospective case series describing the outcome of osteosynthesis for periprosthetic fractures after TKA. MATERIALS AND METHODS: We analyzed the outcome of osteosynthesis for periprosthetic fractures with stable implants in 43 patients having 45 fractures operated between 2010 and 2015. RESULTS: Out of 43 patients, the majority were female (M-15, F-28) with mean age of 65...
January 3, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
R Erivan, T Lecointe, G Villatte, A Mulliez, S Descamps, S Boisgard
INTRODUCTION: The aim of the present study was to assess our management of infected total hip replacement in indications for 2-stage surgical treatment according to current guidelines when a cement spacer has been used. The study hypothesis was that the complications rate related to cement spacers is low. MATERIAL AND METHOD: A single-center retrospective study included 26 patients receiving a spacer between the two stages of total hip replacement, over a 5 year period...
December 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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