Periprosthetic femoral fracture as cause of early revision after short stem hip arthroplasty-a multicentric analysis.

Abstract:

BACKGROUND:The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems. METHODS:A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited. Mean patient age was 57.4 years (range, 18-97 years), with a male ratio of 49.7% (541/1089). Re-operation for any reason within two years was used as an endpoint. The incidence and clinical characteristics of the periprosthetic femoral fractures were also recorded. Mean follow-up period was 5.1 years (range, 2-7.9 years). RESULTS:Early re-operation for any reason was identified in 16 (1.5%) of 1089 hips. The main reason for re-operation was periprosthetic femoral fracture, which accounted for eight (50%) of the 16 re-operations. The overall incidence of periprosthetic femoral fracture at two years was 1.1% (12/1089). According to the Vancouver classification, two fractures were AG type and the other ten were B1 type. Advanced age, higher American Society of Anesthesiologist grade, femur morphology of Dorr type C, and the use of a calcar-loading stem increased the risk for periprosthetic femoral fracture. CONCLUSION:Periprosthetic femoral fracture was the major reason for re-operation after hip replacement surgery using short bone-preserving stems accounting for 50% (8/16) of re-operations two years post-operatively, but did not seem to deteriorate survivorship of implanted prostheses.

journal_name

Int Orthop

authors

Kim SM,Han SB,Rhyu KH,Yoo JJ,Oh KJ,Yoo JH,Lee KJ,Lim SJ

doi

10.1007/s00264-018-3930-y

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

2069-2076

issue

9

eissn

0341-2695

issn

1432-5195

pii

10.1007/s00264-018-3930-y

journal_volume

42

pub_type

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