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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/27917354/results-of-a-hydroxyapatite-coated-femoral-stem-corail-in-chinese-a-minimum-10-year-follow-up
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27812774/optimum-stem-length-for-mitigation-of-periprosthetic-fracture-risk-following-primary-total-knee-arthroplasty-a-finite-element-study
#9
Noel Conlisk, Colin R Howie, Pankaj Pankaj
PURPOSE: Due to age-related changes to the material properties and thinning of the cortical bone structure, older patients with osteoporosis may be at greater risk of femoral fracture following total knee arthroplasty. This study investigates whether there is a potential role for stemmed prostheses in such scenarios to help mitigate peri-implant fracture risk, and if so what should the optimum stem length be to balance surgical bone loss with reduced fracture risk. METHODS: Finite element models of the distal femur implanted with four different implant types: a posterior stabilising implant, a total stabilising implant with short stem (12 mm × 50 mm), a TS implant with medium stem (12 mm × 75 mm), and a TS implant with long stem (12 mm × 100 mm), were developed and analysed in this study...
November 3, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27803221/five-year-outcome-of-proximal-femoral-endoprosthetic-arthroplasty-for-non-tumour-indications
#10
G Grammatopoulos, A Alvand, H Martin, D Whitwell, A Taylor, C L M H Gibbons
OBJECTIVES: A possible solution for the management of proximal femoral bone loss is a modular femoral endoprosthesis (EPR). Although the outcome of EPRs in tumour surgery has been well described, the outcome of their use in revision hip surgery has received less attention. The aim of this study was to describe the outcome of using EPR for non-neoplastic indications. METHODS: A retrospective review of 79 patients who underwent 80 EPRs for non-neoplastic indications was performed, including the rates of complication and survival and the mean Oxford Hip Scores (OHS), at a mean of five years post-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27800463/hemiprosthesis-for-femoral-neck-fractures-in-the-elderly-a-retrospective-study-of-319-patients
#11
Axel Prokop, Marc Chmielnicki
BACKGROUND: In geriatric patients with Pauwels types II and III femoral neck fractures, hemiprosthesis is the therapy of choice. OBJECTIVES: This study was conducted to analyze the results after cemented hemiprosthesis placement, the first year after surgery. PATIENTS AND METHODS: This retrospective study was conducted on 319 patients over 70 years with displaced femoral neck fractures treated surgically at our hospital from 2007 to 2012. All medical information was available including retrospective posthospital discharge records as well as inpatient course and one-year mortality...
September 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/27777917/adjuvant-teriparatide-therapy-for-surgical-treatment-of-femoral-fractures-does-it-work
#12
Jung Taek Kim, Hyung Jun Jeong, Soong Joon Lee, Hee Joong Kim, Jeong Joon Yoo
PURPOSE: Atypical femoral fracture (AFF), periprosthetic femoral fracture (PPFF) and femoral nonunion (FNU) are recalcitrant challenges for orthopedic surgeons. Teriparatide (TPTD) had been demonstrated to have anabolic effects on bone in various studies. We postulated that adjuvant TPTD after operation would enhance biologic stimulation for bone formation. We investigated (1) whether the adjuvant TPTD could achieve satisfactory union rate of surgically challenging cases such as displaced AFF, PPFF and FNU; (2) whether the adjuvant TPTD could promote development of abundant callus after surgical fixation; (3) whether the adjuvant TPTD had medically serious adverse effects...
September 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/27777712/midterm-results-of-consecutive-periprosthetic-femoral-fractures-vancouver-type-a-and-b
#13
Klemens Trieb, Rainer Fiala, Christian Briglauer
Surgical treatment of periprosthetic femoral fractures has a high complication and mortality rate of more than 10%. The aim of this study is to report the outcome of a consecutive single center patient group. Thirty-four consecutive patients (mean age 81.2+/-8.5 years, 14 male, 20 female) with a periprosthetic femoral fracture Vancouver type A (n=5) or type B (n=29) were followed-up after 43.2 months, none of the patients were lost to follow-up. Nineteen of the patients were treated through change of the stem and cerclage fixation, five by plates and ten by cerclage cables...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27766385/use-of-porous-tantalum-components-in-paprosky-two-and-three-acetabular-revision-a-minimum-five-year-follow-up-of-fifty-one-hips
#14
Xavier Flecher, Benjamin Appy, Sébastien Parratte, Matthieu Ollivier, Jean-Noel Argenson
INTRODUCTION: Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. OBJECTIVES: The objective of this study was to analyse the outcome and survivorship of acetabular revision hip arthroplasty using tantalum components for loosening associated with bone loss at a minimum of five-year follow-up...
October 21, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27763959/mortality-following-surgical-management-of-vancouver-b-periprosthetic-fractures
#15
Ida Leah Gitajn, Marilyn Heng, Michael J Weaver, Natalie Casemyr, Collin May, Mark S Vrahas, Mitchel B Harris
OBJECTIVES: The goals of this study are to evaluate mortality after Vancouver B periprosthetic fractures and determine predictors of mortality; compare mortality among patients with loose femoral stems treated with revision arthroplasty versus fixation alone; compare mortality among patients with radiographically "indeterminate" fractures treated with revision or fixation; evaluate the rate of return to surgery for patients who underwent revision compared to fixation. DESIGN: Retrospective study SETTING:: Three academic level 1 trauma centersPatients/Participants: 203 patients treated for Vancouver B periprosthetic fractures INTERVENTION:: N/A MAIN OUTCOME MEASUREMENTS:: The primary outcome measure was mortality...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27759486/preparation-of-the-femoral-bone-cavity-in-cementless-stems-broaching-versus-compaction
#16
Mette H Hjorth, Maiken Stilling, Kjeld Søballe, Poul Torben Nielsen, Poul H Christensen, Søren Kold
Background and purpose - Short-term experimental studies have confirmed that there is superior fixation of cementless implants inserted with compaction compared to broaching of the cancellous bone. Patients and methods - 1-stage, bilateral primary THA was performed in 28 patients between May 2001 and September 2007. The patients were randomized to femoral bone preparation with broaching on 1 side and compaction on the other side. 8 patients declined to attend the postoperative follow-up, leaving 20 patients (13 male) with a mean age of 58 (36-70) years for evaluation...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27720182/plate-fixation-in-periprosthetic-femur-fractures-vancouver-type-b1-trochanteric-hook-plate-or-subtrochanterical-bicortical-locking
#17
Mark Lenz, Karl Stoffel, Heike Kielstein, Keith Mayo, Gunther O Hofmann, Boyko Gueorguiev
INTRODUCTION: Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). METHODS: After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses...
December 2016: Injury
https://www.readbyqxmd.com/read/27694588/the-influence-of-cemented-femoral-stem-choice-on-the-incidence-of-revision-for-periprosthetic-fracture-after-primary-total-hip-arthroplasty-an-analysis-of-national-joint-registry-data
#18
J Palan, M C Smith, P Gregg, S Mellon, A Kulkarni, K Tucker, A W Blom, D W Murray, H Pandit
AIMS: Periprosthetic fracture (PF) after primary total hip arthroplasty (THA) is an uncommon but potentially devastating complication. This study aims to investigate the influence of cemented stem designs on the risk of needing a revision for a PF. PATIENTS AND METHODS: We analysed data on 257 202 primary THAs with cemented stems and 390 linked first revisions for PF recorded in the National Joint Registry (NJR) of England, Wales and Northern Ireland to determine if a cemented femoral stem brand was associated with the risk of having revision for a PF after primary THA...
October 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27687809/management-of-vancouver-b2-and-b3-periprosthetic-proximal-femoral-fractures-by-distal-locking-femoral-stem-cannulok-in-patients-75-years-and-older
#19
Ahmed El-Bakoury, Hazem Hosny, Mark Williams, Jonathan Keenan, Rathan Yarlagadda
BACKGROUND: Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge. METHODS: We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery. RESULTS: The mean follow-up was 44...
August 12, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27682284/the-reliability-and-validity-of-the-unified-classification-system-of-periprosthetic-femoral-fractures-after-hip-arthroplasty
#20
J-F Huang, J-J Chen, J-J Shen, W-X Du, F-C Liu, P-J Tong
The Unified Classification System has expanded and updated the Vancouver Classification System and applied treatment principles to all periprosthetic fractures. This study assessed the reliability and validity of the Unified Classification System for femur fractures after hip arthroplasty. Thirty-eight radiographs were finally evaluated by 6 observers, 3 consultants and 3 trainees. Each observer read the radiographs on 2 separate occasions, independently, at least 2 weeks apart. Interobserver and intraobserver agreement and validity were analyzed, using weighted κ statistics...
August 2016: Acta Orthopaedica Belgica
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