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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#1
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#2
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28275023/bilateral-fixation-of-a-periprosthetic-intertrochanteric-hip-fracture-below-birmingham-hip-resurfacing
#3
J Macdonald, R Pagoti, L Cusick
This case report involves a 59-year-old woman with a traumatic right intertrochanteric hip fracture below a previous Birmingham hip resurfacing (BHR). This woman had almost an identical fracture on the left hip 3 years before which was treated with a proximal femoral locking compression plate. Of note periprosthetic fractures following hip resurfacing are usually subcapital and treated with a revision or conservative management. We present an unusual surgical problem that has occurred twice in the same patient and has been treated effectively on both occasions using proximal femoral plating...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28274617/predictive-model-of-surgical-time-for-revision-total-hip-arthroplasty
#4
Albert Wu, Michael J Weaver, Marilyn M Heng, Richard D Urman
BACKGROUND: Maximizing operating room utilization in orthopedic and other surgeries relies on accurate estimates of surgical control time (SCT). A variety of case and patient-specific variables can influence the duration of surgical time during revision total hip arthroplasty (THA). We hypothesized that these variables are better predictors of actual SCT (aSCT) than a surgeon's own prediction (pSCT). METHODS: All revision THAs from October 2008 to September 2014 from one institution were accessed...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28262457/trochantoplasty-for-total-hip-arthroplasty-in-patients-with-coxa-vara-deformity
#5
Jun-Il Yoo, Javad Parvizi, Ji-Ung Song, Yong-Chan Ha, Young-Kyun Lee, Kyung-Hoi Koo
BACKGROUND: In total hip arthroplasty (THA) of hips with coxa vara, the femoral stems might be inserted in a varus alignment. To avoid varus insertion, we designed a technique, which we termed "trochantoplasty." In this procedure, the medial half of the greater trochanter was removed during THA. METHODS: We evaluated 30 patients (31 hips) who had coxa vara deformity and underwent THA using trochantoplasty at the mean follow-up of 5 years (range, 3-9 years). RESULTS: All stems were inserted in the neutral position...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28261427/causes-of-aseptic-persistent-pain-after-total-knee-arthroplasty
#6
Hong-An Lim, Eun-Kyoo Song, Jong-Keun Seon, Kyung-Soon Park, Young-Joo Shin, Hong-Yeol Yang
BACKGROUND: Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS: Of the total 2,534 cases of primary TKA reviewed, 178 cases were classified as having aseptic persistent pain that was not resolved within 1 year after surgery. Except for the cases with periprosthetic fracture (56 knees), 122 cases of aseptic painful TKA were divided into two groups: intra-articular group (83 knees) and extra-articular group (39 knees)...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28253947/-periprosthetic-femoral-fractures-after-total-hip-replacement-our-results-and-treatment-complications
#7
T Pavelka, M Salášek, D Weisová
PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). The Vancouver classification was used to grade the fractures...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28252475/management-of-interprosthetic-femur-fractures
#8
John A Scolaro, Ran Schwarzkopf
Femoral fractures between a total hip arthroplasty prosthesis and total knee arthroplasty prosthesis, also called interprosthetic fractures, are challenging clinical problems. The number of patients who have undergone ipsilateral primary or revision joint arthroplasty procedures in both the hip and the knee continues to rise, and the number of interprosthetic fractures is increasing, as well. The growing body of biomechanical and clinical literature on interprosthetic fractures reflects the increased frequency of and interest in these injuries...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28249971/proximal-femoral-replacement-in-contemporary-revision-total-hip-arthroplasty-for-severe-femoral-bone-loss-a-review-of-outcomes
#9
A Viste, K I Perry, M J Taunton, A D Hanssen, M P Abdel
AIMS: Loss or absence of proximal femoral bone in revision total hip arthroplasty (THA) remains a significant challenge. While the main indication for the use of proximal femoral replacements (PFRs) is in the treatment of malignant disease, they have a valuable role in revision THA for loosening, fracture and infection in patients with bone loss. Our aim was to determine the clinical outcomes, implant survivorship, and complications of PFRs used in revision THA for indications other than malignancy...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28247009/treatment-of-acetabular-fractures-in-older-patients-introduction-of-a-new-implant-for-primary-total-hip-arthroplasty
#10
H Resch, D Krappinger, P Moroder, A Auffarth, M Blauth, J Becker
BACKGROUND: Fractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required. MATERIALS AND METHODS: Between August 2009 and 2014, 30 cases were reported in which all patients underwent total hip arthroplasty additionally to a customized implant designed as an antiprotrusion cage...
February 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28228786/hydroxyapatite-in-total-hip-arthroplasty-our-experience-with-a-plasma-spray-porous-titanium-alloy-hydroxyapatite-double-coated-cementless-stem
#11
Iacopo Castellini, Lorenzo Andreani, Paolo Domenico Parchi, Enrico Bonicoli, Nicola Piolanti, Francesca Risoli, Michele Lisanti
PURPOSE: Total hip arthroplasty could fail due to many factors and one of the most common is the aseptic loosening. In order to achieve an effective osseointegration and reduce risk of lossening, the use of cemented implant, contact porous bearing surface and organic coating were developed. Aim of this study was to evaluate clinical and radiological mid-term outcomes of a porous titanium alloy/hydroxyapatite double coating manufactured cementless femoral stem applied with "plasma spray" technique and to demonstrate the possibility to use this stem in different types of femoral canals...
September 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28228784/atypical-periprosthetic-acetabular-fracture-in-long-term-alendronate-therapy
#12
Giuseppe Marongiu, Antonio Capone
Bisphosphonates have been commonly used in the treatment of osteoporosis, demonstrating its efficacy in fracture risk reduction. However, even if are generally safe and well tolerated, concerns have emerged about atypical fractures related to its prolonged use. Although atypical femoral fracture are more common, case reports demonstrated that even other skeletal areas can be involved by unusual pattern of fracture. We report a atypical acetabular periprosthetic fracture in a 83-year-old female patient after prolonged alendronate treatment for osteoporosis and isolated acetabular revision surgery...
September 2016: Clinical Cases in Mineral and Bone Metabolism
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
#13
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
#14
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 7, 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
March 2017: Archives of Orthopaedic and Trauma Surgery
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