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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/28095724/reverse-hybrid-total-hip-arthroplasty
#1
Helge Wangen, Leif I Havelin, Anne M Fenstad, Geir Hallan, Ove Furnes, Alma B Pedersen, Søren Overgaard, Johan Kärrholm, Göran Garellick, Keijo Mäkelä, Antti Eskelinen, Lars Nordsletten
Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty Register Association (NARA) has already published 2 papers describing results of reverse hybrid THAs in different age groups. Based on data collected over 2 additional years, we wanted to perform in depth analyses of not only the reverse hybrid concept but also of the different cup/stem combinations used...
January 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28093609/periprosthetic-fracture-around-a-stable-femoral-stem-treated-with-locking-plate-osteosynthesis-distal-femoral-locking-plate-alone-versus-with-cerclage-cable
#2
Young-Soo Shin, Seung-Beom Han
To promote rapid bone healing, an adequate stable fixation implant with a percutaneous reduction instrument should be used for Vancouver type B1 or C fractures. The objective of this study was to describe radiographic and clinical outcomes of patients with periprosthetic fracture (PPF) around a stable femoral stem, treated with a distal femoral locking plate alone or with a cerclage cable. A total of 21 patients with PPF amenable to either a reverse distal femoral locking plate (LCP DF(®)) alone or with a cerclage cable, with a mean age of 75...
January 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#3
Samo K Fokter, Andrej Moličnik, Rajko Kavalar, Primož Pelicon, Rebeka Rudolf, Nenad Gubeljak
BACKGROUND: Increased modularity in total hip arthroplasty (THA) through extra junction between the neck and the femoral stem is gaining popularity among orthopaedic community. However, the advantage of the additional junction is shadowed by an increased risk of mechanical failure. The aim of this study was to describe the exact mechanism of fracture of the modular femoral neck in an uncemented stem. METHODS: Clinical, metallurgical, and mechanical analysis including finite-element modelling and elemental-sensitive tissue analysis with the micro-PIXE method was performed on two patients treated with fully modular primary THA made from Titanium alloy of the same oval taper-cone design...
December 27, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28053254/the-synergy-cementless-femoral-stem-in-primary-total-hip-arthroplasty-at-a-minimum-follow-up-of-15-years
#4
I De Martino, V De Santis, R D' Apolito, P K Sculco, M B Cross, G Gasparini
AIMS: We report on the outcome of the Synergy cementless femoral stem with a minimum follow-up of 15 years (15 to 17). PATIENTS AND METHODS: A retrospective review was undertaken of a consecutive series of 112 routine primary cementless total hip arthroplasties (THAs) in 102 patients (112 hips). There were 60 female and 42 male patients with a mean age of 61 years (18 to 82) at the time of surgery. A total of 78 hips in the 69 patients remain in situ; nine hips in eight patients died before 15 years, and 16 hips in 16 patients were revised...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28043711/total-hip-arthroplasty-with-a-fully-hydroxyapatite-coated-stem-a-cohort-study-during-23-28-years
#5
Olav Reikerås
BACKGROUND: Long-term results of a hydroxyapatite (HA)-coated stem are sparse. We have followed a cohort of patients operated with a grit-blasted titanium stem designed for press-fit insertion and entirely plasma-sprayed with HA up to 28 years. METHODS: In the years 1988-1993, we performed 323 primary total hip arthroplasties in 276 patients (189 women). Their mean age was 48 (15-79) years. During the following years, 83 patients with 88 hips have died, and 18 patients did not attend the follow-up examination, but had no major symptoms according to telephone interviews and control examination...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28042119/periprosthetic-femoral-fractures-and-trying-to-avoid-them-what-is-the-contribution-of-femoral-component-design-to-the-increased-risk-of-periprosthetic-femoral-fracture
#6
A V Carli, J J Negus, F S Haddad
AIMS: Periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) are devastating complications that are associated with functional limitations and increased overall mortality. Although cementless implants have been associated with an increased risk of PFF, the precise contribution of implant geometry and design on the risk of both intra-operative and post-operative PFF remains poorly investigated. A systematic review was performed to aggregate all of the PFF literature with specific attention to the femoral implant used...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28003639/simultaneous-periprosthetic-fractures-of-the-femur-and-the-acetabulum-after-bipolar-hip-arthroplasty
#7
Dionysios-Alexandros Verettas, Pelagia-Paraskevi Chloropoulou, Georgios Drosos, Theodosia Vogiatzaki, Konstantinos Tilkeridis, Konstantinos Kazakos
BACKGROUND Although periprosthetic fractures of the femur are a recognized complication of total hip arthroplasty, periprosthetic fractures of the acetabulum are rare. Simultaneous periprosthetic fractures of both the acetabulum and the femur have not been reported, to our knowledge. CASE REPORT We report a simultaneous fracture of the acetabulum and the femur in a 68-year-old female patient who had previously sustained a subcapital fracture of the femur, treated with a bipolar uncemented prosthesis. We discuss the possible mechanism of this combination of fractures...
December 22, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27992642/revision-total-hip-arthroplasty-using-the-cement-in-cement-technique
#8
Derek F Amanatullah, Graham D Pallante, Lorena V Floccari, George I Vasileiadis, Robert T Trousdale
The cement-in-cement technique is useful in the setting of revision total hip arthroplasty (THA), especially to gain acetabular exposure, change a damaged or loose femoral component, or change the version, offset, or length of a fixed femoral component. The goal of this retrospective study was to assess the clinical and radiographic characteristics of revision THA using the cement-in- cement technique. Between 1971 and 2013, a total of 63 revision THAs used an Omnifit (Osteonics, Mahwah, New Jersey) or Exeter (Howmedica, Mahwah, New Jersey) stem and the cement-in-cement technique at the senior author's institution...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27990462/the-biological-metallic-versus-metallic-solution-in-treating-periprosthetic-femoral-fractures-outcome-assessment
#9
Serafino Carta, Mattia Fortina, Alberto Riva, Luigi Meccariello, Enrico Manzi, Antonio Di Giovanni, Paolo Ferrata
Introduction. The periprosthetic fracture of the femur is, in order of frequency, the fourth leading cause (5.9%) of surgical revision. Our study aims to demonstrate how the grafting of bone splint betters the outcomes. Materials. We treated 15 periprosthetic femoral fractures divided into two groups: PS composed of 8 patients treated with plates and splints and PSS involving 7 patients treated only with plates. The evaluation criteria for the two groups during the clinical and radiological follow-up were the quality of life measured by the Short Form (36) Health Survey (SF-36), Harris Hip Score (HHS), Modified Cincinnati Rating System Questionnaire (MCRSQ), bone healing measured by the Radiographic Union Score (RUS), postoperative complications, and mortality...
2016: Advances in Medicine
https://www.readbyqxmd.com/read/27975352/-periprosthetic-femoral-fractures-classification-and-therapy
#10
K Trieb, C Fialka
Periprosthetic femoral fractures can be categorized into proximal fractures around a hip stem or distally around a knee arthroplasty. This paper focuses on the proximal periprosthetic fractures. It is important to classify the fracture at diagnosis and to perform accurate planning of the surgery. Basically it is necessary to decide if the implant is fixed or loose, in the latter case a revision surgery including the change of the endoprosthesis is neccessary. If the implant is fixed an open reduction and internal fixation can be done...
December 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27967333/more-complications-with-uncemented-than-cemented-femoral-stems-in-total-hip-replacement-for-displaced-femoral-neck-fractures-in-the-elderly
#11
Ghazi Chammout, Olle Muren, Evaldas Laurencikas, Henrik Bodéns, Paula Kelly-Pettersson, Helene Sjöö, André Stark, Olof Sköldenberg
Background and purpose - Total hip replacement (THR) is the preferred method for the active and lucid elderly patient with a displaced femoral neck fracture (FNF). Controversy still exists regarding the use of cemented or uncemented stems in these patients. We compared the effectiveness and safety between a modern cemented, and a modern uncemented hydroxyapatite-coated femoral stem in patients 65-79 years of age who were treated with THR for displaced FNF. Patients and methods - In a single-center, single-blinded randomized controlled trial, we included 69 patients, mean age 75 (65-79) and with a displaced FNF (Garden III-IV)...
December 14, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27955655/short-to-long-term-follow-up-of-total-femoral-replacement-in-non-oncologic-patients
#12
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Dominik Pförringer, Marcel Toepfer, Marc Beirer, Moritz Crönlein, Ruediger von Eisenhart-Rothe, Heinz Mühlhofer
BACKGROUND: Compromised bone stock and heavily impaired structural integrity after multiple endoprosthetic revision surgeries can lead to a comparable condition as encountered in musculoskeletal tumor surgery. Total femoral replacement (TFR) can restore femoral integrity and allow patients to resume ambulation. Even though several authors reported their results of TFR, so far many questions are still on debate: Which patients are at risk to experience low functional outcome? Do complications and clinical outcome after TFR depend on the indication for the surgery (e...
December 12, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27917354/results-of-a-hydroxyapatite-coated-femoral-stem-corail-in-chinese-a-minimum-10-year-follow-up
#13
Jianda Xu, Zikang Xie, Jianning Zhao, Yi Gao, Hong Zhao, Libo Peng, Yuxing Qu
BACKGROUND: Due to the adverse effects of cemented hip arthroplasty, uncemented stems with hydroxyapatite (HA) coating reduces these risks and enhanced integration. The concept of an extensive HA coating for the fixation of a tapered femoral stem (Corail(®)) was introduced, which can achieve durable biological fixation and preserve normal periprosthetic bone activity. Here we describe the clinical and radiological outcome in patients with the Corail(®) stem. METHODS: 92 total hip replacements in 81 patients using the Corail(®) stem were followed-up...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27909122/femoral-impaction-bone-grafting-in-revision-hip-arthroplasty-705-cases-from-the-originating-centre
#14
M J Wilson, S Hook, S L Whitehouse, A J Timperley, G A Gie
AIMS: Femoral impaction bone grafting was first developed in 1987 using morselised cancellous bone graft impacted into the femoral canal in combination with a cemented, tapered, polished stem. We describe the evolution of this technique and instrumentation since that time. PATIENTS AND METHODS: Between 1987 and 2005, 705 revision total hip arthroplasties (56 bilateral) were performed with femoral impaction grafting using a cemented femoral stem. All surviving patients were prospectively followed for a mean of 14...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27889849/principles-of-managing-vancouver-type-b-periprosthetic-fractures-around-cemented-polished-tapered-femoral-stems
#15
REVIEW
Conal Quah, Matthew Porteous, Arthur Stephen
The management of periprosthetic fractures around total hip replacements is a complex and challenging problem. Getting it right first time is an important factor in reducing the morbidity, mortality and financial burden associated with these injuries. Understanding and applying the basic principles of fracture management helps increase the chance of successful treatment. Based on these principles, we suggest a treatment algorithm for managing periprosthetic fractures around polished tapered femoral stems.
November 26, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27889839/what-is-the-fate-of-the-neck-after-a-collum-femoris-preserving-prosthesis-a-nineteen-years-single-center-experience
#16
Matteo Formica, Luca Cavagnaro, Marco Basso, Andrea Zanirato, Augusto Palermo, Lamberto Felli
PURPOSE: The aim of our study is to evaluate long-term outcomes from a cohort of patients treated with collum femoris preserving (CFP) stem correlating neck resorption with comorbidities, clinical outcomes, and complications. METHODS: One hundred seventy-six patients (194 hips) were retrospectively reviewed with a minimum follow-up (f.u.) of ten years. Demographic and surgical data were collected. Clinical and radiological evaluation was performed at the last follow up...
November 26, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27886355/acetabular-spacers-in-2-stage-hip-revision-is-it-worth-it-a-single-centre-retrospective-study
#17
Giorgio Burastero, Marco Basso, Giuliana Carrega, Luca Cavagnaro, Francesco Chiarlone, Carlo Salomone, Gabriele Papa, Lamberto Felli
PURPOSE: The aim of this work is to evaluate an acetabular antibiotic loaded bone cement spacer in 2-stage revision surgery as a potential approach able to reduce complications during the inter-stage period (i.e. dislocation, acetabular wear), as well as simplify 2-stage hip revision surgery and improve hip biomechanics. METHODS: We performed a retrospective comparative study and evaluated clinical, radiological and surgical data of 71 patients affected by periprosthetic hip infection who were treated with 2-stage exchange...
November 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27821999/early-results-of-the-lps%C3%A2-limb-preservation-system-in-the-management-of-periprosthetic-femoral-fractures
#18
M Curtin, C Bryan, E Murphy, C G Murphy, W Curtin
INTRODUCTION: Achieving skeletal fixation in the presence of progressive bone loss is a surgical challenge, especially in cases of periprosthetic fracture (PPF). Unpredictable fracture patterns and preexisting bone loss frequently combine in this patient group. Megaprosthetic arthroplasty allows for immediate mobilisation and shorter periods of rehabilitation. We describe the clinical outcomes of a cohort of LPS™ megaprostheses performed for PPF by a single surgeon at our institution...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818985/bilateral-distal-femoral-fracture-after-total-knee-arthroplasty
#19
Fabrício Bolpato Loures, Jorge Rafael Wenck Motta, Rodrigo Sattamini Pires E Albuquerque, João Maurício Barretto, Naason Trindade Cavanellas
The number of total knee arthroplasties has increased exponentially and their indications have been expanded. This procedure presents challenging complications for orthopedic surgeons that are potentially catastrophic for patients. Here, a rare case of simultaneous bilateral periprosthetic fracture of the knee is reported, with discussion of the causal factors, possible management and prophylaxis.
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27815952/incidence-of-distal-femoral-periprosthetic-fractures-after-total-knee-arthroplasty
#20
Tyler Welch, Richard Iorio, Andrew J Marcantonio, Michael S H Kain, John F Tilzey, Lawrence M Specht, William L Healy
BACKGROUND: The incidence of distal femoral periprosthetic fractures associated with total knee arthroplasty (TKA) has been reported as 0.3% to 2.5%. This study examined the incidence of distal femoral periprosthetic fractures at one hospital over a 16-year period. We hypothesized that the incidence of these fractures would be lowered after the introduction of lugged femoral implants and insertion of a distal femoral intramedullary bone graft during TKA. METHODS: From 1994 to 2010, 4,943 primary TKAs were performed...
November 2016: Bulletin of the Hospital for Joint Diseases
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