scholarly journals Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Xianshang Zeng ◽  
Ke Zhan ◽  
Lili Zhang ◽  
Dan Zeng ◽  
Weiguang Yu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Total Hip ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Hip Screw

scholarly journals Cemented versus uncemented total hip arthroplasty for failed proximal femoral nail anti-rotation fixation in patients with intertrochanteric femur fractures: 5-year results of a retrospective observational study

2020 ◽  
Author(s):  
Wenli Chen ◽  
Mao Shuai ◽  
Jinluan Lin ◽  
Baomin Chen ◽  
Mingdong Zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Secondary Outcome ◽  
Total Hip ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Uncemented Total Hip Arthroplasty

Abstract Background: Cemented or uncemented total hip arthroplasty (CTHA or UTHA) is being increasingly performed in patients with intertrochanteric femur fractures (IFFs) who failed to be treated with proximal femoral nail anti-rotations (PFNA) fixation. The purpose of this study is to compare the clinical outcomes of CTHA or UTHA following prior failed PFNA fixation in patients with IFFs.Methods: Data from 244 patients with IFFs who underwent a conversion of PFNA to CTHA (PCA, n =120) or to UTHA (PUA, n = 124) due to pain and hip disfunction during 2008-2018 were retrospectively analysed. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The mean follow-up was 64 months (range, 57 – 71 months). The Harris hip score (HHS) was the primary outcome; the incidence of major orthopaedic complications was the secondary outcome.Results: At the final follow-up, HHS was 79.54±18.85 vs 75.26±18.27 (PCA vs PUA, p = 0.014). There were significant differences between groups regarding the incidence of prosthesis revision, prosthesis loosening, and periprosthetic fracture (5.8% for PCA vs 14.5% for PUA, p = 0.025; 10.0% for PCA vs 20.1% for PUA, p = 0.027; 3.3% for PCA vs 10.5% for PUA, p = 0.028, respectively). Conclusion: The results of the study demonstrated a significant advantage with respect to HHS and major orthopaedic complication rate in favor of CTHA, as compared to UTHA in patients with a failed PFNA treatment.

Effects of Proximal Femoral Nail Anti-Rotation (PFNA-II) and Artificial Total Hip Arthroplasty (THA) on Unstable Intertrochanteric Femoral Fracture Combined with Severe Osteoporosis

2020 ◽  
Vol 10 (3) ◽  
pp. 413-417
Author(s):  
Xiaosong Chen ◽  
Xunsheng Cheng ◽  
Wuxiu Ma ◽  
Congcong Chen ◽  
Gan Zhang
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Proximal Femoral Nail ◽  
Therapeutic Effects ◽  
Severe Osteoporosis ◽  
Total Hip ◽  
Femoral Nail ◽  
Intertrochanteric Femoral Fracture

The current study was conducted to compare the therapeutic effects of proximal femoral nail antirotation (PFNA-II) and artificial total hip arthroplasty (THA) on elderly Chinese patients with unstable intertrochanteric femoral fracture combined with severe osteoporosis. There were 60 people in each group. The duration of surgery, blood loss, and weight-bearing period when standing on the floor were compared between the two groups (P > 0.05). Harries function scores of both groups increased over time. Scores of THA group were significantly higher than those of PFNA-II group during six- and twelve-months follow-up visit (P < 0.05). In addition, excellent and good rates of hip joint function in THA group were higher than those of PFNA-II group during twelve-month follow-up visit (P < 0.05). The occurrence rates of follow-up complications in both groups showed no statistical significance (P > 0.05). Thus, both PFNA-II and THA have good effects on Chinese elderly patients with unstable intertrochanteric femoral fracture combined with severe osteoporosis.

scholarly journals Poor outcomes for osteoporotic patients undergoing conversion total hip arthroplasty following prior failed dynamic hip screw fixation: a nationwide retrospective cohort study

2019 ◽  
Vol 47 (4) ◽  
pp. 1544-1554 ◽  
Author(s):  
Qian Xu ◽  
Jiajie Lai ◽  
Fan Zhang ◽  
Yangkai Xu ◽  
Fugui Zhu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Dynamic Hip Screw ◽  
Harris Hip Score ◽  
Insurance Company ◽  
Total Hip ◽  
Asian Patients ◽  
Significant Difference ◽  
Hip Screw

Objectives This study was performed to compare the long-term clinical and radiological outcomes of conversion total hip arthroplasty (CTHA) following prior failed InterTan nail (IT) fixation or dynamic hip screw (DHS) fixation in Asian patients with osteoporotic intertrochanteric hip fractures (IHFs) and to clarify which implant tends to be more favourable for CTHA. Methods Records of consecutive Asian patients with osteoporosis who underwent conversion of failed primary unilateral IT or DHS fixation to THA from 2010 to 2013 were extracted from the comprehensive database of the China Pacific Insurance Company Ltd. All consecutive procedures were managed by high-volume surgeons. The primary endpoint was the clinical outcome. The secondary endpoint was the radiological outcome. Results In total, 447 Asian patients with osteoporotic IHFs (DHS, n = 223; IT, n = 224) were assessed during a median follow-up of 46 months (range, 39–53 months). The two groups showed a significant difference in the Harris hip score at final follow-up and in the orthopaedic complication rate (DHS, 20.2%; IT, 9.8%). Conclusion Conversion to THA following prior failed DHS fixation tends to be associated with poorer clinical and radiological outcomes in Asian patients with osteoporotic IHFs than that following prior failed IT fixation.

scholarly journals Ten-year comparison of two different techniques for femoral bone cavity preparation—broaching versus compaction in patients with cementless total hip arthroplasty

2021 ◽  
Vol 2 (12) ◽  
pp. 1035-1042
Author(s):  
Maciej Okowinski ◽  
Mette Holm Hjorth ◽  
Sebastian Breddam Mosegaard ◽  
Jonathan Hugo Jürgens-Lahnstein ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Total Hip ◽  
Stem Subsidence ◽  
Femur Fractures

Aims Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for primary total hip arthroplasty (THA) in terms of migration, clinical, and radiological outcomes. Methods A total of 28 patients received one-stage bilateral primary THA with cementless femoral stems (56 hips). They were randomized to compaction on one femur and broaching on the contralateral femur. Overall, 13 patients were lost to the ten-year follow-up leaving 30 hips to be evaluated in terms of stem migration (using radiostereometry), radiological changes, Harris Hip Score, Oxford Hip Score, and complications. Results Over a mean follow-up period of 10.6 years, the mean stem subsidence was similar between groups, with a mean of -1.20 mm (95% confidence interval (CI) -2.28 to -0.12) in the broaching group and a mean of -0.73 mm (95% CI -1.65 to 0.20) in the compaction group (p = 0.07). The long-term migration patterns of all stems were similar. The clinical and radiological outcomes were similar between groups. There were two intraoperative fractures in the compaction group that were fixed with cable wire and healed without complications. No stems were revised. Conclusion Similar stem subsidence and radiological and clinical outcomes were identified after the use of compaction and broaching techniques of the femur at long-term follow-up. Only the compaction group had intraoperative periprosthetic femur fractures, but there were no long-term consequences of these. Cite this article: Bone Jt Open 2021;2(12):1035–1042.

Neck modularity in total hip arthroplasty: a retrospective study of nine hundred twenty-eight titanium neck implants with a maximum follow-up of eighteen years

2020 ◽  
Vol 44 (11) ◽  
pp. 2261-2266
Author(s):  
Pietro Maniscalco ◽  
Fabrizio Quattrini ◽  
Corrado Ciatti ◽  
Laura Ghidoni ◽  
Giuseppe Ghidoni ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip

scholarly journals Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiguang Yu ◽  
Xiulan Han ◽  
Wenli Chen ◽  
Shuai Mao ◽  
Mingdong Zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Elderly Individuals ◽  
Total Hip ◽  
Femoral Nail ◽  
Uncemented Total Hip Arthroplasty ◽  
Significant Difference

Abstract Background At present, it is unclear which device (uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs). Methods Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA or CTA device following failed PFNAs during 2007–2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate. Results The median follow-up was 65 months (60–69 months). Significant distinctions were observed (87.26 ± 16.62 for UTA vs. 89.32 ± 16.08 for CTA, p = 0.021; 86.61 ± 12.24 for symptomatic UTA vs. 88.68 ± 13.30 for symptomatic CTA, p = 0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p = 0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively). Conclusion For elderly individuals with IFFs who suffered a failed PFNA, CTA devices may have a noteworthy advantage in regard to the revision rate and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.

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