scholarly journals Periprosthetic Femoral Fractures in Total Hip Arthroplasty (THA): Comparison Between Osteosynthesis and Revision

2021 ◽  
Author(s):  
Gianluca Scalici ◽  
Debora Boncinelli ◽  
Luigi Zanna ◽  
Roberto Buzzi ◽  
Laura Antonucci ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Total Hip Arthroplasty ◽  
Internal Fixation ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Total Hip ◽  
Periprosthetic Femoral Fractures ◽  
Oxford Hip Score ◽  
Type Of Fracture

Abstract Background Periprosthetic fractures are challenging complication of hip arthroplasty and a rare injury, but their incidence is increasing. The surgical treatment is demanding to achieve early mobilization and avoid the complications of prolonged recumbency. The aim of this study is to evaluate the clinical outcomes of surgical treatment in periprosthetic femoral fractures of hip arthroplasty, making a comparison between implant revision and reduction and internal fixation of the fracture.Methods Authors retrospectively reviewed a series of 117 patients with total hip arthroplasty treated for periprosthetic femur fractures in the period between January 2013 and March 2018 at a single tertiary referral center. We collected the data of 70 patients who satisfied inclusion criteria. The fractures were classified according to the Unified Classification System (UCS) and randomized in two groups: reduction and internal fixation (G1) or revision arthroplasty (G2). Clinical outcomes were assessed with Oxford Hip Score post and pre-surgery, Barthel Score in relation to CIRS score (Cumulative illness rating scale), the type of fracture and post-operative complications with a minimum follow up of one year.Results Nominal univariable statistical analysis revealed significantly results concerning the difference between the post and pre-operative Oxford Hip Score (D Oxford) with type of treatment (p=0,008) and with the CIRS score (p=0,048). Moreover, we observed a strong significant relationship between type of treatment and type of fracture (P=0,0001). Multivariable analyses revealed that CIRS score was independently associated with Oxford Score improvement after surgery (P=0,024).Conclusions Authors reported how the surgical revision has a better functional outcome in B2 type of fracture than B1 or C, but the chosen treatment should be related to surgeon’s experience and patient’s comorbidities and a multidisciplinary team.

scholarly journals Intraoperative periprosthetic femoral fractures at total hip arthroplasty. Review of classifications and treatment techniques

2019 ◽  
Vol 26 (2) ◽  
pp. 67-72
Author(s):  
E. V Polevoy ◽  
N. V Zagorodniy ◽  
S. V Kagramanov ◽  
G. A Chragyan ◽  
O. A Aleksanyan
Keyword(s):  
Surgical Treatment ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Treatment Technique ◽  
Total Hip ◽  
Treatment Techniques ◽  
Periprosthetic Femoral Fractures ◽  
Classification And Treatment

The review covers the problem of intraoperative periprosthetic femoral fractures at total hip arthroplasty including the causes, classification and treatment techniques. This complication may occur at any step of the intervention, may differ by localization and pattern. All these will determine the preferable surgical treatment technique.

scholarly journals Osteosynthesis and outcomes of traumatic periprosthetic femoral fractures after total hip arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Ali Taha ◽  
ElZaher Hassan ElZaher ◽  
Ibrahim ElGanzoury ◽  
Mostafa Ashoub ◽  
Amr Khairy
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Open Reduction ◽  
Femoral Fractures ◽  
Harris Hip Score ◽  
Total Hip ◽  
Periprosthetic Femoral Fractures ◽  
The Mean

Abstract Purpose The aim of this retrospective study was to investigate the treatment of traumatic periprosthetic femoral fractures with open reduction and internal fixation. The outcomes with the use of the surgical techniques were also reported. Methods Between September 2017 and September 2019, 25 patients with traumatic periprosthetic femoral fractures were managed by open reduction and internal fixation in Ain Shams University Hospital, Egypt. The fixation methods were selected based on the surgeon’s preference. Outcomes were assessed using the Harris Hip Score, visual analogue score (VAS) for pain, and EuroQol 5 Dimensions – 5 Level (EQ5D-5L) prior to and after surgery. Patients were regularly followed up for one year. A P value < 0.05 was considered to be statistically significant. Results The mean age at surgery was 77 years (range, 51 to 95 years), 64% (n = 16) were females. According to the Vancouver classification, there were 1 type AG, 15 type B1, and 9 type C fractures. Postoperative complications included wound site infection (n = 2) and non-union (n = 1). The mean pre-trauma Harris Hip Score was 77.44 ± 8.63 (range, 65 to 90), and the mean Harris Hip Score collected at the final follow-up was 72.47 ± 8.85 (range, 60 to 86) (P < 0.05). The mean pre-trauma VAS was 2.20 ± 1.21 (range, 0 to 4), and the mean VAS recorded at the final follow-up was 3.00 ± 1.41 (range, 0 to 5) (P < 0.05). According to the EQ5D-DL assessed at the final follow-up, no patient felt that their daily life and activities became more problematic. Conclusion This study provided added validation of the current management of periprosthetic femoral fractures after total hip arthroplasty. Using the proper fixation and implant can achieve a reliable fixation and good functional recovery. Level of evidence IVa

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 Cement-in-cement stem revision for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty

2009 ◽  
Vol 80 (5) ◽  
pp. 548-552 ◽  
Author(s):  
Toby W Briant-Evans ◽  
Darmaraja Veeramootoo ◽  
Eleftherios Tsiridis ◽  
Matthew J Hubble
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Type B ◽  
Total Hip ◽  
Stem Revision ◽  
Periprosthetic Femoral Fractures

Total Hip Arthroplasty After Failed Internal Fixation of Proximal Femoral Fractures

2013 ◽  
Vol 28 (1) ◽  
pp. 168-171 ◽  
Author(s):  
Michael J. Archibeck ◽  
Joshua T. Carothers ◽  
Krishna R. Tripuraneni ◽  
Richard E. White
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures ◽  
Total Hip

Periprosthetic Femoral Fractures in Total Hip Arthroplasty

2014 ◽  
Vol 24 (6) ◽  
pp. 556-567 ◽  
Author(s):  
Nicholas E. Ohly ◽  
Michael R. Whitehouse ◽  
Clive P. Duncan
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Total Hip ◽  
Periprosthetic Femoral Fractures
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