scholarly journals Surgery of Vancouver Type B2 Periprosthetic Femoral Fracture after Total Hip Arthroplasty in Elderly Patients: An Alternative way with Internal Fixation

2017 ◽  
Vol 1 (2) ◽  
pp. 1-6 ◽  
Author(s):  
Anais Christophe ◽  
Serge Troussel ◽  
Christine Detrembleur ◽  
Dan Putineanu
Keyword(s):  
Total Hip Arthroplasty ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Periprosthetic Femoral Fracture ◽  
Total Hip

Risk Factors for Periprosthetic Femoral Fracture in Non-cemented Total Hip Arthroplasty Through the Direct Anterior Approach

2021 ◽  
pp. 155633162110508
Author(s):  
Zachary Berliner ◽  
Cameron Yau ◽  
Kenneth Jahng ◽  
Marcel A. Bas ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Parkinson Disease ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Categorical Variables ◽  
Patient Specific ◽  
Periprosthetic Femoral Fracture ◽  
Total Hip ◽  
Increased Risk

Background: Although total hip arthroplasty (THA) performed through the direct anterior (DA) approach is frequently marketed as superior to other approaches, there are concerns about increased risks of intraoperative and early postoperative femoral fracture. Purpose: We sought to assess patient-specific and radiographic risk factors for intraoperative and early postoperative (90-day) periprosthetic femoral fracture (PPFx) following DA approach THA. Methods: We retrospectively reviewed 1107 consecutive, primary, non-cemented DA THAs, performed between April 2009 and January 2015, for intraoperative and early postoperative PPFx. Patients lost to follow-up before 90 days (63), cemented or hybrid THA (52), or early femoral failure for another indication (3) were excluded, yielding 989 hips for analysis. Demographic variables and patient comorbidities were analyzed as risk factors for PPFx. Continuous variables were initially compared with 1-way analysis of variance (ANOVA) and categorical variables with chi-square test. A demographic matched-paired radiographic analysis was performed for femoral stem canal fill and compared using univariate logistic regression. Results: The incidence of perioperative PPFx was 2.02%, including 10 intraoperative and 10 early postoperative fractures. Sustaining a postoperative PPFx was associated with being 70 years old or older with a body mass index (BMI) of less than 25, or with having either osteoporosis or Parkinson disease. Radiographs demonstrated that intraoperative PPFx was associated with stems that filled greater proximally rather than distally. Conclusion: Our cohort study found older age, age over 70 with BMI of less than 25, osteoporosis, and Parkinson disease were associated with increased risk for early postoperative PPFx following DA approach THA. Intraoperative fractures may occur with disproportionate proximal femoral canal fill. Further study can evaluate whether cemented femoral components may mitigate risk in these patient populations.

scholarly journals Total hip arthroplasty for intertrochanteric fracture fixation failure

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Liyun Liu ◽  
Yongqiang Sun ◽  
Linlin Wang ◽  
Qiankun Gao ◽  
Ang Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Fracture Fixation ◽  
Intertrochanteric Fracture ◽  
Joint Function ◽  
Fixation Failure ◽  
Total Hip ◽  
Sf 36

Abstract Background Intertrochanteric fracture is a common fracture suffered by elderly patients. Total hip arthroplasty (THA) is regarded as a salvage operation to restore hip joint function after fixation failure, which remains somewhat controversial due to some clinical potential issues. Methods 18 elderly patients (average age 70.3 years) each with intertrochanteric fracture fixation failure treated with THA between September 2013 and October 2016 were retrospectively analyzed. Internal fixation treatments involved 5 patients who had received proximal femoral nail anti-rotation, 7 who received locking proximal femur plates and 6 who received dynamic hip screws. All patients were treated with THA using biological acetabular prosthesis and hip arthroplasty (HA) coating skillet femoral prosthesis, with the greater trochanter fixed using wire or steel when necessary. Patients’ Harris scores pre- and post-treatment, SF-36 Health Questionnaire score and digital radiology (DR) were used for joint prostheses initial stability and survival evaluation. Results 15 patients completed follow-up periods ranging between 19 and 54 months (mean 26.2 months; 1 patient died from a pulmonary embolism, 1 patient died from pulmonary heart disease 1 year after surgery and 1 patient withdrew for personal reasons). There were no joint infections, periprosthetic fractures or dislocations. The average Harris score increased significantly, from 32.68 ± 12.04 points before surgery to 91.08 ± 5.9 points at 24 months post-treatment. SF-36 scores were significantly increased. Conclusion THA as salvage treatment for failed internal fixation of intertrochanteric femoral fractures in elderly patients significantly reduced hip pain and restored joint function, and early clinical outcomes were satisfactory.

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