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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/28222211/the-learning-curve-for-the-direct-anterior-approach-for-total-hip-arthroplasty-a-single-surgeon-s-first-500-cases
#1
James M Hartford, Michael J Bellino
BACKGROUND: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty. PURPOSE: The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach. METHODS: The 1st 500 primary total hip arthroplasties are reviewed. The patients were evaluated out to 3 months. Rates of major complications, reoperations, periprosthetic fractures, heterotopic ossification, leg length discrepancies and lateral femoral cutaneous nerve deficits were identified for each of 100 patients...
February 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28218379/the-corail-stem-as-a-reverse-hybrid-survivorship-and-x-ray-analysis-at-10-years
#2
Helge Wangen, Lars Nordsletten, Jens G Boldt, Anne M Fenstad, David E Beverland
BACKGROUND: 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.We report our experience of reverse hybrid THA, using the Elite plus polyethylene cemented cup together with the Corail fully hydroxyapatite-coated uncemented stem and a 28-mm alumina ceramic head. PATIENTS AND METHODS: 132 consecutive reverse hybrid hip arthroplasties were performed from January 2000 to December 2003 in 126 patients with a mean age of 54...
February 8, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28209401/the-effect-of-prophylactic-cerclage-wires-in-primary-total-hip-arthroplasty-a-biomechanical-study
#3
Andrew C Waligora, John R Owen, Jennifer S Wayne, Shane R Hess, Gregory J Golladay, William A Jiranek
BACKGROUND: Despite literature to support the use of various cerclage techniques to address intraoperative femoral fractures in total hip arthroplasty, there are limited data to support prophylactic cerclage wiring of the femur during cementless implant placement. This study aims to evaluate the effect of prophylactic calcar cerclage wires on the biomechanical parameters required to produce periprosthetic femoral fractures and on the morphology of these fracture patterns in stable cementless femoral implants...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202208/survivorship-analysis-of-eighty-revised-hip-arthroplasties-with-the-impaction-grafting-technique-using-whole-femoral-head-allografts-with-the-articular-cartilage
#4
Ahmed Fadulelmola, Efstathios Drampalos, John Hodgkinson, Mukesh Hemmady
BACKGROUND: Acetabular impaction bone grafting aims to restore anatomy in hip revision surgery. This is an effective but expensive and time-consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. We aimed to reproduce the same results retaining the cartilage of the allograft. METHODS: Eighty acetabular revisions using impacted morselized bone graft retaining the articular cartilage and a cemented cup were studied retrospectively...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28194710/exchangeable-femoral-neck-dual-modular-tha-prostheses-have-poorer-survivorship-than-other-designs-a-nationwide-cohort-of-324-108-patients
#5
Sandrine Colas, Assia Allalou, Antoine Poichotte, Philippe Piriou, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28165600/early-periprosthetic-joint-infection-and-debridement-antibiotics-and-implant-retention-in-arthroplasty-for-femoral-neck-fracture
#6
Carl Mellner, Thomas Eisler, Björn Knutsson, Sebastian Mukka
INTRODUCTION: Periprosthetic joint infection (PJI) is a severe complication of hip arthroplasty for femoral neck fractures (FNF). Debridement, antibiotics and implant retention (DAIR) is recommended in early PJI in association with stable implants. Few studies have evaluated the outcome of DAIR in this fragile population.The purpose of this study was to analyse risk factors for PJI and the short-term outcome of DAIR in FNF patients treated with a hip arthroplasty. METHODS: A consecutive series of 736 patients (median age 81 years, 490 women, 246 men) had been treated with either a total hip arthroplasty or a hemi hip arthroplasty for a displaced FNF at our institution...
January 31, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#7
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28154993/outcome-of-extensive-varus-and-valgus-stem-alignment-in-short-stem-tha-clinical-and-radiological-analysis-using-ebra-fca
#8
Karl Philipp Kutzner, Tobias Freitag, Stefanie Donner, Mark Predrag Kovacevic, Ralf Bieger
INTRODUCTION: The principle of implanting a calcar-guided short stem consists of an individual alignment alongside the medial calcar providing the ability of reconstructing varus and valgus anatomy in a great variety. However, still, there are broad concerns about the safety of extensive varus and valgus positioning in regard to stability, bony alterations, and periprosthetic fractures. MATERIALS AND METHODS: 216 total hip arthroplasties using a calcar-guided short stem (optimys, Mathys Ltd...
February 2, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28150224/isolated-acetabular-revision-with-femoral-stem-retention-after-bipolar-hip-arthroplasty
#9
Nobuhiro Kaku, Tomonori Tabata, Hiroaki Tagomori, Hiroshi Tsumura
INTRODUCTION: In bipolar hemiarthroplasty, migration of the outer cup component into the acetabular cup, with evidence of severe osteolysis in the acetabulum, commonly occurs without loosening of the femoral component. The merits of retaining the stable femoral component in these cases have been debated. Our study aimed to determine whether revision of the acetabular component in isolation could be successfully performed. MATERIALS AND METHODS: The data of 54 patients (61 hips), 44 women, and 10 men, aged 67...
February 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28148660/results-of-the-cemented-exeter-femoral-component-in-patients-under-the-age-of-40-an-update-at-ten-to-20-years-follow-up
#10
M W J L Schmitz, E Bronsema, D C J de Kam, J W M Gardeniers, R P H Veth, B W Schreurs
AIMS: We carried out a further study of the long-term results of the cemented Exeter femoral component in patients under the age of 40 with a mean follow-up of 13.6 years (10 to 20). PATIENTS AND METHODS: We reviewed our original cohort of 104 cemented Exeter stems in 78 consecutive patients with a mean age of 31 years (16 to 39). Only one patient was lost to radiological follow-up. RESULTS: A total of six patients (eight hips) had died for reasons unrelated to their surgery...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28137262/direct-anterior-approach-for-total-hip-arthroplasty-with-a-novel-mobile-traction-table-a-prospective-cohort-study
#11
Junichi Nakamura, Shigeo Hagiwara, Sumihisa Orita, Ryuichiro Akagi, Takane Suzuki, Masahiko Suzuki, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: The purpose of this prospective cohort study was to clarify the safety and efficacy of total hip arthroplasty via the direct anterior approach in the supine position with a novel mobile traction table. METHODS: The first experience of consecutive surgeries by a single surgeon using the direct anterior approach with a traction table is described with a two-year follow-up period. Of 121 patients, 100 patients without previous hip surgeries, severe deformity, or cemented implants were divided into two groups comprising the first 50 patients and the second 50 patients...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28131543/predictors-of-functional-recovery-following-periprosthetic-distal-femur-fractures
#12
John A Ruder, Gavin P Hart, Jeffrey S Kneisl, Bryan D Springer, Madhav A Karunakar
BACKGROUND: Treatment options for periprosthetic distal femur fractures include open reduction internal fixation (ORIF) and distal femoral replacement (DFR). The purpose of this study was to evaluate the complications, and functional recovery (ambulatory status, living situation, mortality) in patients undergoing operative treatment (DFR and ORIF) of periprosthetic distal femur fractures. METHODS: A retrospective review of 58 patients with distal femoral periprosthetic fractures treated with either ORIF or DFR was conducted...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28130016/cortical-strut-allograft-support-of-modular-femoral-junctions-during-revision-total-hip-arthroplasty
#13
Chin Tat Lim, Derek F Amanatullah, James I Huddleston, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: There is risk of junction failure when using modular femoral stems for revision total hip arthroplasty (THA), especially with loss of bone stock in the proximal femur. Using a cortical strut allograft may provide additional support of a modular femoral construct in revision THA. METHODS: We reviewed prospectively gathered clinical and radiographic data for 28 revision THAs performed from 2004 to 2014 using cementless modular femoral components with cortical strut allograft applied to supplement proximal femoral bone loss: 5 (18%) were fluted taper designs and 23 (82%) were porous cylindrical designs All the patients had a Paprosky grade IIIA or greater femoral defect...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#14
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28116505/total-hip-arthroplasty-after-failed-treatment-of-proximal-femur-fracture
#15
Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoyuki Noda, Tomoko Tetsunaga, Toru Sato, Naofumi Shiota, Toshifumi Ozaki
INTRODUCTION: Total hip arthroplasty (THA) is a good option as a salvage procedure after failed treatment of proximal femur fracture. The anatomy of the proximal femur, however, makes this surgery complicated and challenging. The purpose of this study was to evaluate the radiographic and clinical outcomes of THA after failed treatment of proximal femur fractures. MATERIALS AND METHODS: We retrospectively analysed 50 consecutive THAs (42 women, 8 men; mean age 77 years) after failed treatment of a proximal femur fracture...
January 23, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28095724/reverse-hybrid-total-hip-arthroplasty
#16
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
#17
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
#18
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
#19
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
#20
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
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