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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/28721591/secondary-femur-shaft-fracture-following-treatment-with-cephalomedullary-nail-a-retrospective-single-center-experience
#1
Nikolaus W Lang, J Joestl, S Payr, P Platzer, K Sarahrudi
AIM: Secondary femur fracture subsequent to treatment of trochanteric fractures with cephalomedullary nailing (i.e., a periprosthetic fracture related to the cephalomedullary nail) is a rare but very severe complication. As such, the aim of this study was to assess the impact of revision surgery and general state of health on mortality and functional outcomes in patients suffering femur fractures following treatment with cephalomedullary nails. MATERIALS AND METHODS: Between 2000 and 2015, 3549 patients presenting with OTA/AO 31A1-3 femur fractures were admitted to our department and subsequently treated with either a Gamma(®) Nail or PFNA(®)...
July 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28712800/hip-arthroplasty-after-surgical-treatment-of-intertrochanteric-hip-fractures
#2
Brandon J Yuan, Matthew P Abdel, William W Cross, Daniel J Berry
BACKGROUND: Although use of intramedullary hip screws (IMHS) for intertrochanteric (IT) hip fractures has become more common, limited data have suggested difficulties in conversion to hip arthroplasty. The present study investigates whether conversion of failed IT fracture fixation with an intramedullary vs extramedullary device leads to different rates or types of complications or decreased arthroplasty survivorship. METHODS: One hundred eleven patients were converted to hip arthroplasty after previous surgical treatment of an IT fracture from 2000 to 2010...
June 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28690039/retained-antibiotic-spacers-after-total-hip-and-knee-arthroplasty-resections-high-complication-rates
#3
Stephen M Petis, Kevin I Perry, Mark W Pagnano, Daniel J Berry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: Prolonged retention of an antibiotic spacer is occasionally chosen during treatment of periprosthetic joint infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of our study was to evaluate the outcome of extended spacer retention. METHODS: We reviewed 1106 cases of periprosthetic joint infection after THA (n = 308) and TKA (n = 798) and identified 17 (5.5%) retained hip and 34 (4.3%) retained knee spacers. Most patients (35 of 51, 69%) underwent spacer retention because they were medically unfit for further surgery...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28689273/locking-attachment-plate-fixation-around-a-well-fixed-stem-in-periprosthetic-femoral-shaft-fractures
#4
Min Bom Kim, Jae-Woo Cho, Young Ho Lee, Won-Yong Shon, Jung Wee Park, Jinil Kim, Jong-Keon Oh
INTRODUCTION: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture. MATERIALS AND METHODS: Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014...
July 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28681674/total-hip-arthroplasty-after-failed-osteosynthesis-of-proximal-femoral-fractures-revision-and-mortality-of-80-patients
#5
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
https://www.readbyqxmd.com/read/28676374/reduced-incidence-of-intraoperative-femur-fracture-with-a-second-generation-tapered-wedge-stem
#6
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...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28669018/revision-knee-arthroplasty-using-a-distal-femoral-replacement-prosthesis-for-periprosthetic-fractures-in-elderly-patients
#7
Ehab Girgis, Christoph McAllen, Jonathan Keenan
PURPOSE: Distal femoral periprosthetic fractures above a total knee replacement in elderly patients are technically challenging to treat. Bone quality is often poor, the fractures comminuted, and post-operative mobilisation is difficult. This study assesses the clinical, radiological and functional outcome of revision knee distal femoral replacement (DFR) in these fractures. METHODS: We identified 14 patients over 70 years of age (70-94) who underwent DFR for periprosthetic fractures above a knee replacement...
July 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28665453/good-mid-term-clinical-results-of-a-cemented-dual-mobility-cup-a-single-centre-experience
#8
Gregor Kavčič, Pika Mirt, Klemen Bedenčič
INTRODUCTION AND METHODS: From January 2004 to December 2008, 188 total hip arthroplasties were performed using a cemented dual mobility cup. 174 patients were available for final analysis. Their mean age was 76.8 (range 54-98 years). The mean follow-up was 7.7 years (range 5-10 years). RESULTS: There were no dislocations. Survivorship rates of the femoral and acetabular components were 100% at a minimum of 5 years. At the latest follow-up, the mean Harris Hip Score significantly increased from 31...
June 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28663398/cardiac-disease-and-advanced-age-increase-the-mortality-risk-following-surgery-for-periprosthetic-femoral-fractures
#9
S Märdian, C Perka, K-D Schaser, J Gruner, F Scheel, P Schwabe
AIMS: Periprosthetic fracture is a significant complication of total hip and knee arthroplasty. This study aimed to describe the survival of patients sustaining periprosthetic femoral fractures and compare this with that of the general population, as well as to identify the factors that influence survival. PATIENTS AND METHODS: A total of 151 patients (women: men 116:35, mean age 74.6 years, standard deviation 11.5) that sustained a periprosthetic fracture between January 2005 and October 2012 were retrospectively analysed...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28662252/chronic-expanding-hematoma-after-metal-on-metal-total-hip-arthroplasty
#10
Wataru Ando, Kengo Yamamoto, Tsuyoshi Koyama, Yoshichika Hashimoto, Hirohiko Yasui, Takashi Tsujimoto, Masaharu Aihara, Kenji Ohzono
A 76-year-old woman who underwent bilateral metal-on-metal total hip arthroplasty fell 3 years after this procedure and subsequently incurred continuous pain in her buttock. Plain radiographs showed no fracture and no loosening of the hip prosthesis. Magnetic resonance imaging revealed an abnormal, large, thick-walled mass with heterogeneous signal intensity at the right buttock. The prerevision diagnosis was adverse reaction to metal debris. The mass was surgically resected, and the metal femoral head was replaced by a dual-mobility prosthesis...
June 29, 2017: Orthopedics
https://www.readbyqxmd.com/read/28660436/adventure-sports-and-sexual-freedom-hip-replacement-the-tripolar-hip
#11
James W Pritchett
Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations...
June 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28641972/equal-primary-fixation-of-resurfacing-stem-but-inferior-cup-fixation%C3%A2-with-anterolateral-vs-posterior-surgical-approach-a-2-year-blinded-randomized-radiostereometric-and-dual-energy-x-ray-absorptiometry-study-of-metal-on-metal-hip-resurfacing-arthroplasty
#12
Mette H Hjorth, Nina D Lorenzen, Kjeld Søballe, Stig S Jakobsen, Maiken Stilling
BACKGROUND: The anterolateral (AntLat) surgical approach may spare the blood supply to the femoral head and improve the accuracy of cup positioning in metal-on-metal hip resurfacing arthroplasty. Thereby, potentially lessen complications such as avascular head necrosis, femoral neck narrowing and fracture, improve implant fixation, and lessen periprosthetic bone mineral density (BMD) loss. METHODS: Between November 2008 and January 2012, a randomized clinical trial was performed at Aarhus University Hospital...
May 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641194/use-of-a-long-distally-fixed-intramedullary-stem-to-treat-a-periprosthetic-femoral-fracture-following-total-hip-arthroplasty-using-a-thrust-plate-hip-prosthesis-a-case-report
#13
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...
June 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28622117/periprosthetic-femoral-fractures-in-the-emergency-department-what-the-orthopedic-surgeon-wants-to-know
#14
Richard A Marshall, Michael J Weaver, Aaron Sodickson, Bharti Khurana
Femoral fracture in the setting of a hip arthroplasty is an increasingly common complication encountered in the emergency department (ED). Diagnosis and management of periprosthetic fractures are complicated, and orthopedic surgeons rely on imaging findings to guide the appropriate management approach to the injury. Delay in identification and appropriate definitive management of periprosthetic fractures is associated with high morbidity and mortality. At present, the Vancouver classification system for periprosthetic hip fractures is the most common classification system used by orthopedic surgeons...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28599634/the-mayo-conservative-hip-complication-analysis-and-management-of-the-first-41-cases-performed-at-a-university-level-1-department
#15
Jörg Arnholdt, Fabian Gilbert, Marc Blank, Jannis Papazoglou, Maximilian Rudert, Ulrich Nöth, Andre F Steinert
BACKGROUND: To prevent bone loss in hip arthroplasty, several short stem systems have been developed, including the Mayo conservative hip system. While there is a plethora of data confirming inherent advantages of these systems, only little is known about potential complications, especially when surgeons start to use these systems. METHODS: In this study, we present a retrospective analysis of the patients' outcome, complications and the complication management of the first 41 Mayo conservative hips performed in 37 patients...
June 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28591963/-extensively-porous-coated-distal-fixation-long-stem-prosthesis-for-unstable-proximal-femur-fracture-with-complex-hip-disease
#16
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
https://www.readbyqxmd.com/read/28574123/orthogonal-plating-of-vancouver-b1-and-c-type-periprosthetic-femur-fracture-nonunions
#17
Christopher E Birch, Michael Blankstein, Jesse D Chlebeck, Craig S Bartlett Rd
BACKGROUND: Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). METHODS: A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28567150/cortical-fenestration-for-megaprosthesis-stem-revision
#18
Vincent Y Ng, Philip Louie, Stephanie Punt, Ernest U Conrad Iii
BACKGROUND: The most common modes of failure for megaprostheses are aseptic loosening followed by periprosthetic infection and stem fracture. Surgical technique for bone and implant exposure is controversial and may influence the success of revision and the need for additional future revisions. The purpose of this study was to evaluate the effectiveness of cortical fenestration for megaprosthesis revision, particularly for stem fracture. METHODS: From 1985-2014, 196 adult and pediatric patients underwent limb salvage with a distal femoral or proximal tibial megaprosthesis (109 cemented, 87 pressfit)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28566786/short-and-mid-term-results-of-revision-total-knee-arthroplasty-with-global-modular-replacement-system
#19
Dariusz Marczak, Jacek Kowalczewski, Jarosław Czubak, Tomasz Okoń, Marek Synder, Marcin Sibiński
BACKGROUND: The original knee megaprostheses with fixed or rotating hinge articulation were custom made and only used for reconstruction of the knee following distal femoral or proximal tibial tumor resections. The aim of the study was to analyze the short- and mid-term results of revision total knee arthroplasty with Global Modular Replacement System (GMRS) used in difficult situations not amenable to reconstruction with standard total knee replacement implants. MATERIALS AND METHODS: Nine patients (9 knees) were treated with this comprehensive modular implant system, with a mean age of 73...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28566392/mid-term-results-of-the-biolox-delta-ceramic-on-ceramic-total-hip-arthroplasty
#20
Y K Lee, Y C Ha, J-I Yoo, W L Jo, K-C Kim, K H Koo
AIMS: We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. PATIENTS AND METHODS: Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival...
June 2017: Bone & Joint Journal
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