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Periprosthetic femoral fractures

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https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#1
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28913406/long-term-results-of-a-porous-tantalum-monoblock-tibia-component-clinical-and-radiographic-results-at-follow-up-of-10-years
#2
Daniel Gerscovich, Catherine Schwing, Anthony Unger
BACKGROUND: The purpose of this study is to assess the long-term follow-up of cementless total knee arthroplasty with the trabecular metal (TM) monoblock tibial component at an average 10-year follow-up. This report is an extension of our previously reported series of 108 TM tibias reported in 2011 (Unger and Duggan, 2011). METHODS: Fifty-eight of the original 108 knees were available for review. Each follow-up patient was evaluated by radiologic and clinical Knee Society Scores...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28900737/the-benefit-of-the-systematic-revision-of-the-acetabular-implant-in-favor-of-a-dual-mobility-articulation-during-the-treatment-of-periprosthetic-fractures-of-the-femur-a-49-cases-prospective-comparative-study
#3
A Perrin, M Saab, S Putman, K Benad, E Drumez, C Chantelot
INTRODUCTION: The SOFCOT symposium (2005) on periprosthetic fractures of the femur (PFFs) highlighted a high rate of dislocation (15.6% at 6 months) after change of prosthesis. So far, no study has ever proved the benefit of dual-mobility articulation during PFFs revisions. We conducted a comparative study on two prospective cohorts in order to (1) assess the influence of systematic acetabular revision in favor of a double mobility on dislocation rate (2) and in order to evaluate the rate of morbidity associated with this extra surgical procedure...
September 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28899823/a-predictive-radiological-analysis-of-short-stems-versus-both-shortened-and-long-stems-in-primary-hip-replacement-a-case-control-study-of-100-cases-of-metha-versus-abg-ii-and-omnifit-ha-at-2-8-years-follow-up
#4
Jean-Alain Epinette, Michel Brax, Yves Chammaï
INTRODUCTION: Short hip stems, intended to conserve bone stock and ensure a more physiological distribution of stress in the femur under loading, are meeting with renewed interest. Radiologic semiology is not known exactly, particularly in relation to conventional implants; we therefore conducted a case-control study of 3 types of implant differing only in stem length: short, shortened or long. The aim was 1) to compare radiographic aspects, 2) to attempt to systematize medium-term radiologic status for the 3 types, and 3) to assess the impact of radiographic aspect on loosening and revision rates...
September 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28870190/monobloc-implants-in-cementless-total-hip-arthroplasty-in-patients-with-legg-calve-perthes-disease-a-long-term-follow-up
#5
Ze-Yu Luo, Hao-Yang Wang, Duan Wang, Hui Pan, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD). METHODS: We reviewed 71 patients (88 hips) who underwent cementless THA with a diagnosis of LCPD from 2003 to 2009. From the total of 71 patients, 34 men and 37 women with an average age of 49.94 years were included. The mean follow-up period was 10 years. RESULTS: The mean Harris Hip Score improved significantly from 46...
September 5, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28869116/teriparatide-administration-increases-periprosthetic-bone-mineral-density-after-total-knee-arthroplasty-a-prospective-study
#6
Tatsuya Suzuki, Fumio Sukezaki, Takashi Shibuki, Yoichi Toyoshima, Takashi Nagai, Katsunori Inagaki
BACKGROUND: Teriparatide is a currently available therapeutic agent for osteoporosis. Previous studies have reported that teriparatide affects periprosthetic bone mineral density (BMD) after total knee arthroplasty (TKA). However, little agreement has been reached concerning the treatment of periprosthetic BMD after TKA with teriparatide. Moreover, BMD in the femoral and tibial sides of the joints together has never been examined. We investigated the efficacy of teriparatide to inhibit BMD loss in the femoral and tibial side and considered complications such as migration and periprosthetic fractures after TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28852332/radiographic-risk-factors-for-interprosthetic-femur-fractures
#7
Jason S Lipof, Ari D Amitai, Kyle T Judd, John T Gorczyca
PURPOSE: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common orthopaedic procedures performed in the United States annually. As the number of patients undergoing these procedures increases so too does the incidence of periprosthetic femur fractures. A number of these periprosthetic fractures occur between two ipsilateral implants, so-called interprosthetic fractures. Recent biomechanical data has challenged the importance of these interprosthetic distances, relating that cortical width and osteoporotic bone are more closely correlated with fracture than interprosthetic distance...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844629/total-hip-arthroplasty-after-in-situ-fixation-of-minimally-displaced-femoral-neck-fractures-in-elderly-patients
#8
Nicholas M Hernandez, Brian P Chalmers, Kevin I Perry, Daniel J Berry, Brandon J Yuan, Matthew P Abdel
BACKGROUND: In situ screw fixation remains the most common treatment for minimally displaced femoral neck fractures (FNFs). Total hip arthroplasty (THA) can be used as a salvage procedure, but the results of conversion THA in this population have not been evaluated. The goals of this study were to evaluate (1) unique complications associated with conversion THA, (2) implant survivorship free of revision and reoperation, (3) radiographic results, and (4) clinical outcomes in patients undergoing conversion THA after in situ fixation of nondisplaced FNFs...
July 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28739307/conservative-treatment-for-minimally-displaced-type-b-periprosthetic-femoral-fractures
#9
Young-Kyun Lee, Jung Taek Kim, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Surgical treatment has been invariably indicated for Vancouver type B periprosthetic femoral fractures (PFFs), which involve femoral diaphysis around stem. We evaluated the outcomes of nonoperative management in patients with minimally displaced type B PFFs around cementless stem. METHODS: From October 2009 to March 2016, 60 type B PFFs were treated at 1 institution. Among them, 19 minimally (<5 mm) displaced PFFs (31.7%, 19/60), which occurred around cementless stems, were treated nonsurgically with use of teriparatide...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28721591/secondary-femur-shaft-fracture-following-treatment-with-cephalomedullary-nail-a-retrospective-single-center-experience
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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