PUBIC RAMUS INSUFFICIENCY FRACTURES FOLLOWING TOTAL HIP ARTHROPLASTY

2003 ◽  
Vol 85 (9) ◽  
pp. 1819-1822 ◽  
Author(s):  
CORY G. CHRISTIANSEN ◽  
RIDA A. KASSIM ◽  
JOHN J. CALLAGHAN ◽  
J. LAWRENCE MARSH ◽  
ANDREW H. SCHMIDT
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Insufficiency Fractures ◽  
Pubic Ramus ◽  
Total Hip

RAMUS PUBIS INSUFFICIENCY FRACTURES AFTER TOTAL HIP ARTHROPLASTY: PHYSIOLOGICAL AND BIOMECHANICAL CONSIDERATIONS

2008 ◽  
Vol 11 (04) ◽  
pp. 181-184 ◽  
Author(s):  
Nachoum Galit ◽  
Brosh Tamar ◽  
Salai Moshe ◽  
Tytiun Yehezkel ◽  
Dudkiewicz Israel
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Symptoms ◽  
Weak Link ◽  
Three Dimensional ◽  
Element Model ◽  
Insufficiency Fractures ◽  
Pubic Ramus ◽  
Medical Practitioners ◽  
Total Hip

Although uncommon, pubic ramus fractures are described in patients who have undergone total hip arthroplasty (THA). We describe two females with superior ramus pubis insufficiency fractures following THA. We consider the physiological and biomechanical aspects of those fractures, e.g. that the superior ramus pubis has the highest load stress on the pelvis (as has already been proved in a three-dimensional finite element model). Also being discussed are risk factors (intrinsic and extrinsic) for stress fractures and the management of insufficiency fractures. Both women suffered osteoporosis, obesity, and had a semisedentary lifestyle — all of which are known risks factors for insufficiency superior ramus pubis fracture to occur in a location which proved as a "weak link" zone after THA. Many of these fractures are undetected, mainly due to the lack of awareness of medical practitioners who attribute the clinical symptoms to other diseases; however, the differential diagnosis of groin pain within the first years following THA should include pubic ramus insufficiency fractures.

Does Total Hip Arthroplasty Influence the Development and Localization of Sacral Insufficiency Fractures?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Isabel Graul ◽  
Patrick Strube ◽  
Sophia Vogt ◽  
Georg Matziolis ◽  
Steffen Brodt ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Insufficiency Fractures ◽  
Total Hip ◽  
Sacral Insufficiency Fractures

Risk analysis of patients with an osteolytic acetabular defect after total hip arthroplasty using subject-specific finite-element modelling

2018 ◽  
Vol 100-B (11) ◽  
pp. 1455-1462 ◽  
Author(s):  
J. T. Munro ◽  
J. S. Millar ◽  
J. W. Fernandez ◽  
C. G. Walker ◽  
D. W. Howie ◽  
...  
Keyword(s):  
Finite Element ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Von Mises Stress ◽  
Mineral Density ◽  
Pubic Ramus ◽  
Total Hip ◽  
Subject Specific ◽  
Von Mises

Aims Osteolysis, secondary to local and systemic physiological effects, is a major challenge in total hip arthroplasty (THA). While osteolytic defects are commonly observed in long-term follow-up, how such lesions alter the distribution of stress is unclear. The aim of this study was to quantitatively describe the biomechanical implication of such lesions by performing subject-specific finite-element (FE) analysis on patients with osteolysis after THA. Patients and Methods A total of 22 hemipelvis FE models were constructed in order to assess the transfer of load in 11 patients with osteolysis around the acetabular component of a THA during slow walking and a fall onto the side. There were nine men and two women. Their mean age was 69 years (55 to 81) at final follow-up. Changes in peak stress values and loads to fracture in the presence of the osteolytic defects were measured. Results The von Mises stresses were increased in models of those with and those without defects for both loading scenarios. Although some regions showed increases in stress values of up to 100%, there was only a moderate 11.2% increase in von Mises stress in the series as a whole. The site of fracture changed in some models with lowering of the load to fracture by 500 N. The most common site of fracture was the pubic ramus. This was more frequent in models with larger defects. Conclusion We conclude that cancellous defects cause increases in stress within cortical structures. However, these are likely to lead to a modest decrease in the load to fracture if the defect is large (> 20cm3) or if the patient is small with thin cortical structures and low bone mineral density. Cite this article: Bone Joint J 2018;100-B:1455–62.

Sign in / Sign up

Export Citation Format

Share Document