scholarly journals Intrapelvic Migration of the Lag Screw in Intramedullary Nailing

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Tomoya Takasago ◽  
Tomohiro Goto ◽  
Shunichi Toki ◽  
Daisuke Hamada ◽  
Shinji Yoshioka ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Rare Complication ◽  
Femoral Fractures ◽  
The Elderly ◽  
Careful Attention ◽  
Lag Screw ◽  
Medial Migration

Internal fixation with intramedullary devices has gained popularity for the treatment of intertrochanteric femoral fractures, which are common injuries in the elderly. The most common complications are lag screw cut out from the femoral head and femoral fracture at the distal tip of the nail. We report here a rare complication of postoperative lag screw migration into the pelvis with no trauma. The patient was subsequently treated with lag screw removal and revision surgery with total hip arthroplasty. This case demonstrated that optimal fracture reduction and positioning of the lag screw are the most important surgical steps for decreasing the risk of medial migration of the lag screw. Furthermore, to prevent complications, careful attention should be paid to subsequent steps such as precise insertion of the set screw.

scholarly journals Patient and implant survival following intraoperative periprosthetic femoral fractures during primary total hip arthroplasty

2019 ◽  
Vol 101-B (10) ◽  
pp. 1199-1208 ◽  
Author(s):  
Jonathan N. Lamb ◽  
Gulraj S. Matharu ◽  
Anthony Redmond ◽  
Andrew Judge ◽  
Robert M. West ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Cox Regression ◽  
Patient Survival ◽  
Femoral Fractures ◽  
Trochanteric Fracture ◽  
Total Hip ◽  
Periprosthetic Femoral Fractures ◽  
Primary Total Hip Arthroplasty

Aims We compared implant and patient survival following intraoperative periprosthetic femoral fractures (IOPFFs) during primary total hip arthroplasty (THA) with matched controls. Patients and Methods This retrospective cohort study compared 4831 hips with IOPFF and 48 154 propensity score matched primary THAs without IOPFF implanted between 2004 and 2016, which had been recorded on a national joint registry. Implant and patient survival rates were compared between groups using Cox regression. Results Ten-year stem survival was worse in the IOPFF group (p < 0.001). Risk of revision for aseptic loosening increased 7.2-fold following shaft fracture and almost 2.8-fold after trochanteric fracture (p < 0.001). Risk of periprosthetic fracture of the femur revision increased 4.3-fold following calcar-crack and 3.6-fold after trochanteric fracture (p < 0.01). Risk of instability revision was 3.6-fold after trochanteric fracture and 2.4-fold after calcar crack (p < 0.001). Risk of 90-day mortality following IOPFF without revision was 1.7-fold and 4.0-fold after IOPFF with early revision surgery versus uncomplicated THA (p < 0.001). Conclusion IOPFF increases risk of stem revision and mortality up to ten years following surgery. The risk of revision depends on IOPFF subtype and mortality risk increases with subsequent revision surgery. Surgeons should carefully diagnose and treat IOPFF to minimize fracture progression and implant failure. Cite this article: Bone Joint J 2019;101-B:1199–1208

scholarly journals Anterior Subluxation after Total Hip Replacement Confirmed by Radiographs: Report of Two Cases

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Conor P. McGrory ◽  
Brian J. McGrory
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Rare Complication ◽  
Unusual Complication ◽  
Total Hip ◽  
Anterior Subluxation

Demonstrable anterior subluxation of the femoral head after a total hip arthroplasty is a rare complication and is usually transient. Both a case of recurrent subluxation and a case of chronic subluxation are described in this paper, each one presenting with unexpected femoral head eccentricity in the acetabulum on radiograph. We show how this unusual complication can be successfully identified and treated.

scholarly journals Horror of three synergistic factors in THA: high mechanical stress, dissimilar metals, low elasticity stem: a case report

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Seiya Ishii ◽  
Yasuhiro Homma ◽  
Takehisa Matsukawa ◽  
Tomonori Baba ◽  
Ayano Kubota ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Large Diameter ◽  
Femoral Stem ◽  
Frictional Torque ◽  
Cobalt Chromium ◽  
Total Hip ◽  
Metal Head

Abstract Background A large-diameter femoral head is effective in preventing dislocation after total hip arthroplasty. However, although rare, catastrophic stem tribocorrosion may occur at the head-stem junction. Case presentation A 70-year-old woman underwent revision surgery 7.5 years after total hip arthroplasty because of catastrophic stem corrosion with dissociation of the metal head (cobalt/chromium) and stem (TiMo12Zr6Fe2). Abnormal levels of cobalt were found in the intra-articular fluid, capsule, hip muscle, and blood. Revision surgery was performed via the direct anterior approach. The well-fixed femoral stem was explanted, and a cemented stainless stem with stainless head was implanted. Three months after the revision surgery, the cobalt concentration in the blood had decreased to normal. Conclusions Stem dissociation in the present case might have been caused by synergistic combination of a 36-mm-diameter femoral head and long neck length offset with high frictional torque, a cobalt-chromium head with a high risk of galvanic corrosion, and a TMZF (TiMo12Zr6Fe2) alloy stem with a low Young’s modulus of elasticity. The combination of these factors must be avoided.

Fatal Fat Embolism following Femoral Head Resection in Total Hip Arthroplasty

2008 ◽  
Vol 18 (4) ◽  
pp. 332-334 ◽  
Author(s):  
N.M. Walker ◽  
T. Bateson ◽  
P. Reavley ◽  
D. Prakash
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Rare Complication ◽  
Femoral Shaft ◽  
Fat Embolism ◽  
Total Hip ◽  
Intramedullary Reaming ◽  
Embolism Syndrome ◽  
Primary Total Hip Arthroplasty

We report a rare complication during primary total hip arthroplasty. A fatal fat pulmonary embolism immediately followed removal of the femoral head, prior to further preparation of the acetabulum or femoral shaft. Fat embolism syndrome is a well-known complication during total joint arthroplasty, usually attributed to preparation of the femoral shaft, particularly intramedullary reaming and insertion of the prosthesis. These risk factors have previously been identified in the literature. We believe that this case highlights the need for further research to establish the intramedullary pressures during the processes of dislocation and resection of the femoral neck and the attendant risk.

scholarly journals Medial Pelvic Migration of the Lag Screw after Intramedullary Nailing for Trochanteric Femoral Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kohei Kuroshima ◽  
Koichi Kasahara ◽  
Shinsuke Kihara ◽  
Yoshifumi Harada ◽  
Masatoshi Sumi
Keyword(s):  
Femoral Fracture ◽  
Rare Complication ◽  
Femoral Fractures ◽  
Careful Attention ◽  
Older Individuals ◽  
Intramedullary Nails ◽  
Screw Insertion ◽  
Lag Screw ◽  
Trochanteric Femoral Fracture ◽  
Femoral Side

Internal fixation with intramedullary nails has gained popularity for the treatment of trochanteric femoral fractures, which are common injuries in older individuals. The most common complications are lag screws cut-out from the femoral head and femoral fracture at the distal tip of the nail. Herein, we report a rare complication of postoperative medial pelvic migration of the lag screw with no trauma. The patient was subsequently treated by lag screw removal via laparoscopy. This case suggests that optimal fracture reduction, adequate position of the lag screw, and careful attention to set screw insertion are important to prevent complications. Additionally, laparoscopic surgery might be able to remove the lag screw more safely than removal from the femoral side.

scholarly journals Femoral Head-Trunnion Dissociation in Metal-on-Polyethylene Total Hip Arthroplasty – A Unique Case Report

2018 ◽  
Vol 7 (4) ◽  
Author(s):  
Nick N. Patel ◽  
George N. Guild III ◽  
Greg A. Erens
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Rare Complication ◽  
Case Series ◽  
Acute Onset ◽  
Future Research ◽  
Contributing Factors ◽  
Total Hip

Background: Gross trunnion failure (GTF) after total hip arthroplasty is a rare complication and has only been reported in a few case series. Some of the associated risk factors have been described in the literature and include larger femoral heads, greater offset, and increased BMI. Despite this, the mechanism behind GTF is poorly understood and early diagnosis and treatment continues to be challenging.Case Presentation: We present the case of complete femoral head and trunnion dissociation in a 63 year-old female nine years after total hip arthroplasty. Unique to this case is the lack of classic patient and implant risk factors for GTF along with the acute onset nearly nine years after implantation. Discussion: This case presentation highlights the fact that the contributing factors and mechanism behind GTF continue to be poorly understood. There is a need for future research to help better understand this phenomenon and to help potentially identify those at risk for GTF.

scholarly journals Late Occurring Medial Migration of a Lag Screw in Gamma Nailing

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
S. van Hoef ◽  
M. C. H. W. Fuchs ◽  
R. H. M. ten Broeke
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acute Pain ◽  
Gamma Nail ◽  
Unusual Complication ◽  
Third Generation ◽  
Lag Screw ◽  
Medial Migration ◽  
Gamma Nailing

An 81-year-old female was treated for a pertrochanteric multifragmentary fracture of the proximal femur with a third-generation Gamma nail. After 3 months she presented herself again with acute pain and inability to bear weight on the leg. Radiographs showed medial migration of the lag screw. She was treated with a total hip arthroplasty, after which she was successfully discharged. In this case report the possible causes of this late and unusual complication are discussed.

scholarly journals Dual mobility total hip arthroplasty: should everyone get one?

2019 ◽  
Vol 4 (9) ◽  
pp. 541-547 ◽  
Author(s):  
William G. Blakeney ◽  
Jean-Alain Epinette ◽  
Pascal-André Vendittoli
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Patient Selection ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Polyethylene Liner ◽  
Fixed Bearing ◽  
Hip Instability ◽  
Dual Mobility ◽  
Total Hip

Hip instability following total hip arthroplasty (THA) remains a major challenge and is one of the main causes of revision surgery. Dual mobility (DM) implants have been introduced to try to overcome this problem. The DM design consists of a small femoral head captive and mobile within a polyethylene liner. Numerous studies have shown that DM implants reduce the rate of dislocation compared to fixed-bearing inserts. Early designs for DM implants had problems with wear and intra-prosthetic dislocations, so their use was restricted to limited indications. The results of the latest generation of DM prostheses demonstrate that these problems have been overcome. Given the results of these studies presented in this review, surgeons may now consider DM THA for a wider patient selection. Cite this article: EFORT Open Rev 2019;4:541-547. DOI: 10.1302/2058-5241.4.180045

scholarly journals Acetabular Liner Dissociation following Total Hip Arthroplasty: A Rare but Serious Complication That May Be Easily Misinterpreted in the Emergency Department

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Christopher K. J. O’Neill ◽  
Richard J. Napier ◽  
Owen J. Diamond ◽  
Seamus O’Brien ◽  
David E. Beverland
Keyword(s):  
Emergency Department ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Rare Complication ◽  
Correct Diagnosis ◽  
Acetabular Liner ◽  
Total Hip ◽  
Radiological Features

Acetabular liner dissociation is a rare complication of Total Hip Arthroplasty (THA) which requires urgent revision surgery. A case is presented in which the correct diagnosis was not appreciated on two separate Emergency Department attendances. The typical symptoms, signs, and radiological features are outlined and the importance of considering a rare complication following a commonly performed procedure is highlighted.

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