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Periprosthetic Fracture

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https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#1
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/28054110/-periprosthetic-acetabular-fractures-in-geriatric-patients
#2
S C Herath, M F R Rollmann, T Histing, J H Holstein, T Pohlemann
Periprosthetic acetabular fractures in geriatric patients are rare injuries; however, the incidence is increasing because of the current demographic developments. For diagnosis of periprosthetic acetabular fractures, conventional X‑ray images are regularly complemented by computed tomography (CT). For exclusion of loosening of the prosthesis more advanced techniques, such as single photon emission CT (SPECT/CT) are applied. In addition to classification of periprosthetic acetabular fractures by the traditional system of Letournel there are several other classification systems, which take into account the etiology of the fracture and the stability of the prosthesis...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28053254/the-synergy-cementless-femoral-stem-in-primary-total-hip-arthroplasty-at-a-minimum-follow-up-of-15-years
#3
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
#4
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
#5
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/28026733/long-term-function-following-periprosthetic-fractures
#6
J Zwingmann, M Krieg, F Thielemann, N Südkamp, P Helwig
PURPOSE OF THE STUDY Clinical results of long-term follow-up after traumatic periprosthetic femur fractures and different therapies (ORIF vs. revision arthroplasty) MATERIAL AND METHODS The Visual Analog Scale (VAS), Harris-Hip-Score (HHS), Oxford-Hip-Score (OHS), Oxford-Knee-Score (OKS), Knee-Society-Score (KSS), SF-36 Questionnaire and Funktionsfragebogen Hannover (FFH) were used to evaluate outcome and functionality. Radiological examinations were performed and the Vancouver (THA) and Lewis and Rorabeck (TKA) classifications used...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28013577/plate-fixation-of-periprosthetic-femur-fractures-what-happens-to-the-cement-mantle
#7
Lukas Konstantinidis, Benjamin Schmidt, Anke Bernstein, Anja Hirschmüller, Steffen Schröter, Norbert Paul Südkamp, Peter Helwig
Osteosynthesis of periprosthetic femur fractures by screw fixation around the implanted prosthetic stem is currently regarded as the biomechanically superior option compared with cerclage. The aim of this biomechanical study was damage analysis of the cement mantle after revision screw insertion. A prosthetic stem (Bicontact) was implanted in 20 cadaveric femora in cemented technique. A locking compression plate (Synthes) was then applied to the lateral femur at the level of the prosthetic stem. The method of plate fixation to the femur was assigned randomly to three groups: bicortical non-locking screws, monocortical locking screws, and bicortical locking screws...
December 1, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28004292/corr-insights-%C3%A2-periprosthetic-occult-fractures-of-the-acetabulum-occur-frequently-during-primary-tha
#8
Enrique Gomez-Barrena
No abstract text is available yet for this article.
December 21, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28003639/simultaneous-periprosthetic-fractures-of-the-femur-and-the-acetabulum-after-bipolar-hip-arthroplasty
#9
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/28002219/do-transcortical-screws-in-a-locking-plate-construct-improve-the-stiffness-in-the-fixation-of-vancouver-b1-periprosthetic-femur-fractures-a-biomechanical-analysis-of-2-different-plating-constructs
#10
Jasjit Lochab, Andrew Carrothers, Edwin Wong, Stewart McLachlin, Wassim Aldebeyan, Richard Jenkinson, Cari Whyne, Markku T Nousiainen
OBJECTIVES: This biomechanical study compared Vancouver B1 periprosthetic femur fractures fixed with either a locking plate and anterior allograft strut construct or an equivalent locking plate with locking attachment plates construct in paired cadaveric specimens. METHODS: After 9 pairs of cadaveric femora were implanted with a cemented primary total hip arthroplasty, an oblique osteotomy was created distal to the cement mantle. Femora underwent fixation with either: (1) a locking plate with anterior strut allograft (locking compression plating (LCP)-Allograft) or (2) a locking plate with 2 locking attachment plates (LAPs) (LCP-LAP)...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27993444/two-stage-revisions-for-culture-negative-infected-total-knee-arthroplasties-a-five-year-outcome-in-comparison-with-one-stage-and-two-stage-revisions-for-culture-positive-cases
#11
Heng Li, Ming Ni, Xiang Li, Qingmeng Zhang, Xin Li, Jiying Chen
BACKGROUND: Culture-negative periprosthetic joint infection (PJI) is very intractable when dealing with an infected total knee arthroplasty (TKA) patient. Two-stage revision has been proved to be a reliable solution for PJI patients. Whether it is still credible for culture-negative infected patients remains uncertain. METHODS: Our group retrospectively reviewed all total knee revision patients from January 2003 to January 2014, 145 PJI patients were diagnosed as infection with the PJI diagnostic criteria and 129 patients were successfully followed...
December 16, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27992642/revision-total-hip-arthroplasty-using-the-cement-in-cement-technique
#12
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
#13
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
#14
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
#15
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
#16
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/27942735/total-humeral-endoprosthesis-replacement-to-salvage-periprosthetic-fractures-in-rheumatoid-arthritis
#17
Andy Tanagho, Barnes Morgan, Matt Ravenscroft
The authors report their experience in the management of a 53-year-old woman with rheumatoid arthritis who presented with bilateral asynchronous traumatic periprosthetic fractures of the humerus after bilateral elbow replacements. One side was treated with a long-stem revision and internal fixation with bone graft, while the other side was treated with a long-stem distal humeral replacement. She sustained pathological periprosthetic fractures on top of the long-stemmed implants. Total humeral endoprosthesis replacements were performed bilaterally as salvage procedures to provide a stable platform for her elbow and hand function...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27926677/transfemoral-amputation-after-failure-of-knee-arthroplasty-a-nationwide-register-based-study
#18
Tinne B Gottfriedsen, Henrik M Schrøder, Anders Odgaard
BACKGROUND: Transfemoral amputation is considered the last treatment option for failed knee arthroplasty. The extent to which this procedure is performed is not well known. The purpose of this study was to identify the incidence and causes of amputation following failure of knee arthroplasty in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27917354/results-of-a-hydroxyapatite-coated-femoral-stem-corail-in-chinese-a-minimum-10-year-follow-up
#19
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
#20
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
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