scholarly journals Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sheng-Yu Jin ◽  
Jing-Yao Jin ◽  
Min-Gwang Kim ◽  
Woo-Jong Kim ◽  
Taek-Rim Yoon ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Subtrochanteric Fracture ◽  
Subtrochanteric Fractures ◽  
Cementless Total Hip Arthroplasty ◽  
Previously Treated ◽  
The Mean

Abstract Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor limb function. Cementless total hip arthroplasty (THA) could serve as an efficient salvage procedure in such cases. This study aimed to evaluate the outcomes and complications of salvage THA in failed subtrochanteric fracture fixation cases. Methods From January 2001 to December 2017, cementless THA for failed treatment of subtrochanteric fractures was performed in 18 hips of 11 men and 7 women (average age, 74 years; age range, 57.0–89.0 years). Patients were followed up for clinical and radiological assessments in terms of implant survival and complications after a minimum follow-up of 2 years. The Wagner femoral stems (Zimmer, Warsaw, USA) were used in all 18 patients (100%), with the long-length stem (Wagner SL stem) and standard-length stem (Wagner cone stem) used in 11 and 7 patients, respectively. Results The mean follow-up period was 5.2 years (range: 2.2–10.8 years). The mean Harris hip score (HHS) was 38.2 (range: 24–56) preoperatively and 85.4 (range: 79–92) at the last follow-up. The mean postoperative limb length discrepancy was 6.4 mm (range: 4–9 mm). Only one patient underwent revision due to bone in-growth failure of the femoral stem. One patient had an episode of postoperative dislocation and was treated with closed reduction without reoccurrence. Delayed union of the fracture site occurred in one patient. Patients who were previously treated with an intramedullary nail had a significantly shorter surgical duration, lesser intraoperative blood loss, and fewer blood transfusions than those who were previously treated with plate and screws. Kaplan–Meier survival rate with an endpoint of revision was 94.4% (95% confidence interval 72.7–99.9) at 5 years. Conclusion Our results indicate that cementless THA is a beneficial and effective procedure for salvaging the failed treatment of subtrochanteric fractures. The Wagner conical prosthesis has shown satisfactory function outcomes, stable fixation, and survival rate for these complex situations. However, attention should be paid to increased operation time, blood loss, and complications when performing THA for subtrochanteric fractures with failed fixation devices especially, plates and screws.

scholarly journals Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

2020 ◽  
Author(s):  
Sheng-Yu Jin ◽  
Jing-Yao Jin ◽  
Woo-Jong Kim ◽  
Taek-Rim Yoon ◽  
Kyung-Soon Park
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Intramedullary Nail ◽  
Subtrochanteric Fracture ◽  
Subtrochanteric Fractures ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Mean

Abstract Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor function. Cementless total hip arthroplasty (THA) could be an option as a salvage procedure in such cases. This study was to evaluate the clinical and radiological results and complications of this treatment in our hospital. Method Eighteen cementless THAs for failed treatment of subtrochanteric fractures were performed at our institution between January 2001 to December 2017. There were eleven males and seven females, and the average age was 74 years (range 57.0-89.0). Eight patients were previously operated with an intramedullary nail, six patients were treated with a dynamic hip screw, two patients were treated with an angled blade plate, one patient was treated with a proximal femur locking plate, and one patient was treated with a dynamic compression plate. Results The mean follow-up was 5.2 years (range 2.2-10.8). The mean duration of the operation was 98.0 minutes (standard deviation [SD],15.4; range 70-135). The mean total blood loss was 992.2 mL (SD,171.2; range 640-1260 mL), and the amount of transfusion was 2.2 units (SD, 0.8, range 1-4). The mean Harris hip score (HHS) was 38.2 (SD, 9.3; range, 24-56) preoperatively and 85.4 (SD, 4.9; range, 79-92) at the last follow-up. Compared to the patients treated with plate-screws, those treated with an intramedullary nail had significantly shorter surgical duration, fewer blood transfusions, and less intraoperative blood loss. Kaplan-Meier survivorship with an endpoint of revision was 94.4% (95% confidence interval 72.7-99.9) at five years. Conclusion Cementless THA is one of the acceptable procedures for failed treatment of the subtrochanteric fracture with fewer complications.

scholarly journals Treatment of Crowe IV developmental dysplasia of the hip with cementless total hip arthroplasty and shortening subtrochanteric osteotomy

2019 ◽  
Vol 47 (7) ◽  
pp. 3223-3233 ◽  
Author(s):  
Tang Liu ◽  
Sisi Wang ◽  
Guoliang Huang ◽  
Wanchun Wang
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Mean ◽  
Dysplasia Of The Hip

Objective This study was performed to document the clinical and radiographic results of consecutive patients with Crowe IV developmental dysplasia of the hip (DDH) treated by cementless total hip arthroplasty (THA) using an S-ROM femoral component with shortening derotational subtrochanteric osteotomy. Methods Twenty-three hips of 21 patients with Crowe IV DDH were treated by cementless THA combined with shortening derotational subtrochanteric osteotomy from January 2005 to January 2011. The mean preoperative modified Harris hip score (mHHS) and University of California, Los Angeles (UCLA) activity score were 40.7 and 4.2, respectively. Results The mean follow-up was 105 months. The mean mHHS and UCLA score improved to 87.0 and 9.1, respectively, at the latest follow-up. Nine of the 23 hips had a negative Trendelenburg sign. One of the 23 hips was outside the Lewinnek acetabular cup inclination safe range, and 3 of the 23 hips were outside the Lewinnek acetabular cup anteversion safe range. The probability of prosthesis survival was 100% at 5 years and 91.3% at 10 years. Conclusion Patients with Crowe IV DDH can be treated by cementless THA combined with shortening derotational subtrochanteric osteotomy. This method can greatly improve hip joint function and relieve pain without significant complications.

scholarly journals Custom Cementless Femoral Stems in Total Hip Arthroplasty

2019 ◽  
Vol 03 (02) ◽  
pp. 068-072
Author(s):  
Glenn D. Wera ◽  
Mark W. Dwyer ◽  
Daniel R. Verhotz ◽  
Matthew A. Popa ◽  
Randall E. Marcus
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Long Term Results ◽  
Complication Rates ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Femur Fractures ◽  
Femoral Stems ◽  
The Mean

AbstractObtaining appropriate prosthetic fit in cementless total hip arthroplasty can be challenging in cases with disparity between the femoral and metaphyseal diameters of the femur or cases of complex deformity. One solution has been to utilize a custom femoral component in total hip arthroplasty. The long-term results of this option with respect to femoral morphology are limited. This cohort was analyzed to determine the survivorship, functional results using Harris Hip Scores (HHSs), and complication rates using these implants. Survivorship and complications were evaluated based on the proximal femoral anatomy and severity of arthritis. The authors retrospectively reviewed 73 cases of custom femoral implants in total hip arthroplasties by a single surgeon. The average age of patients at index surgery was 58.06 years (range, 36.00–73.75 years). The mean follow-up was 8.59 years (range, 0.17–20.33 years) with a minimum of 2-year follow-up required for analysis of HHS data. There were 8 failures at a mean of 67.68 months (range, 2.04–135 months). The reasons for revision were infection (2), osteolysis (1), periprosthetic fracture (3), osteolysis and aseptic loosening (1), and polyethylene wear (1). The mean preoperative HHS was 55.38 (range, 31–90). The mean follow-up HHS was 93.10 (range, 38–100) with a mean improvement of 37.44 (p < 0.0001). Complications included infection (3), fracture (6), and dislocation (3). Preoperative Dorr classification A (n = 44), B (n = 24), and C (n = 1) and Kellgren–Lawrence grades I (n = 0), II (n = 2), III (n = 7), and IV (n = 60) were not predictive of failure or revision (p = 0.45, p = 0.6). There was a near significant association between Dorr classification B femur fractures requiring revision (p < 0.053). Kaplan–Meier predicted survivorship was 20.33 years with revision for any reason as the endpoint and total overall survivorship of 81.7%. Custom cementless femoral stems provide satisfactory survivorship and improvement in hip scores in a variety of patients undergoing cementless total hip arthroplasty. Fracture rates are higher in Dorr class B femurs. The level of evidence was IV.

Cementless Total Hip Arthroplasty in Hip Dysplasia with an Extensively Porous-Coated Cylindrical Stem Modified for Asians: A 12-Year Follow-Up Study

2015 ◽  
Vol 30 (6) ◽  
pp. 1014-1018 ◽  
Author(s):  
Tsutomu Kato ◽  
Takuya Otani ◽  
Hajime Sugiyama ◽  
Tetsuo Hayama ◽  
Souichi Katsumata ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Dysplasia ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Follow Up Study

scholarly journals Cementless Total Hip Arthroplasty Using Titanium, Plasma-Sprayed Implants: A Study with 10 to 15 Years of Follow-up

2011 ◽  
Vol 19 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Javier Sanz-Reig ◽  
Alejandro Lizaur-Utrilla ◽  
Isabel Llamas-Merino ◽  
Fernando Lopez-Prats
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Plasma Sprayed

Cementless Total Hip Arthroplasty Using VerSys Fiber Metal Midcoat Stem: a Minimum 3-Years Follow-up

2010 ◽  
Vol 22 (1) ◽  
pp. 45 ◽  
Author(s):  
Ju Hyung Yoo ◽  
Sung-Guk Kim ◽  
Chang-Dong Han ◽  
Hyun Chul Oh ◽  
Han Kook Yoon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Fiber Metal

scholarly journals 5-Year Clinical and Radiographic Results of the Direct Anterior Approach for Total Hip Arthroplasty Using a Collared Cementless Femoral Short-Stem Prosthesis

2022 ◽  
Vol 11 (2) ◽  
pp. 346
Author(s):  
Ali Darwich ◽  
Kim Pankert ◽  
Andreas Ottersbach ◽  
Marcel Betsch ◽  
Sascha Gravius ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Hip Osteoarthritis ◽  
Direct Anterior Approach ◽  
Short Stem ◽  
Total Hip ◽  
The Mean

The aim of this study was to investigate the radiological and clinical outcome of the direct anterior approach (DAA) in total hip arthroplasty (THA) using a collared cementless femoral short-stem. This retrospective study included 124 patients with 135 THAs operated from 2014 to 2016 using a collared cementless triple tapered hydroxyapatite-coated femoral short-stem (AMIStem H Collared®, Medacta International, Castel San Pietro, Switzerland) implanted with a DAA. Follow-up was performed at three months, 12 months, and five years. Clinical outcome was assessed using the hip osteoarthritis outcome score (HOOS) and radiological analysis was done using conventional radiographs, which included evaluation of the femur morphology based on Dorr classification, of radiolucencies based on the Gruen zone classification and of stem subsidence. The mean age was 67.7 ± 11.3 years and the mean body mass index (BMI) was 27.4 ± 4.4 kg/m2. The stem survival rate at five years was 99.1% with one revision due to recurrent dislocations. Mean HOOS score improved from 40.9 ± 18.3 preoperatively to 81.5 ± 19.7 at three months, 89.3 ± 10.9 at 12 months, and 89.0 ± 14.0 at five years (all with p < 0.001). No significant correlations were found between age, femoral bone morphology, BMI and HOOS, and the appearance of relevant radiolucencies.

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