Treatment of Femoral Fractures Associated with Stem Loosening following Total Hip Arthroplasty

1998 ◽  
Vol 8 (3) ◽  
pp. 138-144 ◽  
Author(s):  
B. Erdemli ◽  
I. Gurkan ◽  
B. Guzel ◽  
I. Cetin
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Fractures ◽  
Early Mobilization ◽  
Revision Operation ◽  
Hip Revision ◽  
Total Hip ◽  
Primary Hip Arthroplasty ◽  
Fractures Of The Femur

We report the results of Kent hip revision arthroplasties performed in 5 patients with fractures of the femur associated with femoral loosening following total hip arthroplasty. The fractures occurred at an average of 40.4 months following the primary hip arthroplasty. The system of Merle D'Aubigné and Postel, as modified by Charnley, was used for the clinical evaluation. One to four years (mean, 2.6 years) after the revision operation, the clinical and radiographic results were satisfactory. With the help of the transfixion screws the Kent Hip prosthesis provides stable fixation and facilitates early mobilization, with its attendant advantages.

Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Contact System ◽  
Factor Xii ◽  
Total Hip ◽  
Activity Factor ◽  
Patient Groups ◽  
Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

Treatment of Displaced Neck Fractures of the Femur With Total Hip Arthroplasty

2012 ◽  
Vol 27 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Sergio Rudelli ◽  
Sergio P. Viriato ◽  
Tadeu L.O. Meireles ◽  
Tiago N. Frederico
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Fractures Of The Femur

Intraoperative Femoral Fractures Associated With Cementless Total Hip Arthroplasty

Orthopedics ◽  
1989 ◽  
Vol 12 (2) ◽  
pp. 231-239 ◽  
Author(s):  
Thomas H Mallory ◽  
Thomas J Kraus ◽  
Bradley K Vaughn
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

scholarly journals Acetabular Fractures in the Elderly

2015 ◽  
Vol 6 ◽  
pp. CMTIM.S12265 ◽  
Author(s):  
Joshua L. Gary
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Revision Arthroplasty ◽  
Early Mobilization ◽  
Acetabular Fractures ◽  
Posttraumatic Arthritis ◽  
Total Hip

As the population ages, the incidence of osteoporotic fractures, including those of the pelvis and acetabulum, continues to rise. Treatment of the elder patients with an acetabular fracture is much more controversial than the treatment of younger patients with similar injuries, where prevention of posttraumatic arthritis and total hip replacement remains optimal to limit need for revision arthroplasty. Arthroplasty for fractures of the proximal femur is commonplace in an older population and is a mainstay of treatment to promote early mobilization and weight-bearing. However, even with acute total hip arthroplasty for a geriatric acetabular fracture, most surgeons do not permit immediate weight-bearing postoperatively. Therefore, controversy regarding optimal treatment of these challenging fractures persists. Four treatment options have emerged: nonoperative treatment with early mobilization, open reduction and internal fixation (ORIF), limited open reduction and percutaneous screw fixation, and acute total hip arthroplasty. The exact indications and benefits of each treatment remain unknown. This article serves as a review of these four treatments and the data existing to support them.

scholarly journals Impact of stem design and cementation on postoperative femoral antetorsion in 227 patients with total hip arthroplasty (THA)

2020 ◽  
Vol 49 (12) ◽  
pp. 2001-2009
Author(s):  
Tim Fischer ◽  
Christoph Stern ◽  
Benjamin Fritz ◽  
Patrick O. Zingg ◽  
Christian W. A. Pfirrmann ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Stem ◽  
Stem Design ◽  
Femoral Antetorsion ◽  
Total Hip ◽  
Posterior Condylar ◽  
Lower Variability

Abstract Objective In total hip arthroplasty (THA), surgeons attempt to achieve a physiological antetorsion. However, postoperative antetorsion of the femoral stem is known to show large variabilities. The purpose of this study was to assess whether postoperative antetorsion is influenced by stem design or cementation. Materials and methods This retrospective study included 227 patients with a hip prosthesis with five different stem designs (S1: short curved, S2 and S3: standard straight, S4: standard straight collared, S5: cemented straight), who had metal suppressed 1.5T-MRI of the hip between February 2015 and October 2019. Measurement of femoral antetorsion was done independently by two fellowship-trained radiologists on axial images by measuring the angle between the long axis of the femoral neck and the posterior condylar tangent of the knee. Measured angles in the different groups were compared using the t test for independent samples. Results The cementless collared stem S4 showed the highest antetorsion with 18.1° (± 10.5°; range –10°–45°), which was significantly higher than the antetorsion of the collarless S3 with 13.3° (± 8.4°; − 4°–29°) and the cemented S5 with 12.7° (± 7.7°; − 3°–27°) with p = 0.012 and p = 0.007, respectively. S1 and S2 showed an antetorsion of 14.8° (± 10.0°; 1°–37°) and 14.1° (± 12.2°; − 20°–41°). The torsional variability of the cementless stems (S1–4) was significantly higher compared with that of the cemented S5 with a combined standard deviation of 10.5° and 7.7° (p = 0.019). Conclusion Prosthesis design impacts the postoperative femoral antetorsion, with the cementless collared stem showing the highest antetorsion. Cemented stems demonstrated significantly lower variability, suggesting the lowest rate of inadvertent malrotation.

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

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