PURPOSE: In case of stem loosening in periprosthetic femoral fractures (PPFF), revision arthroplasty should be performed. The first hypothesis of this study was that advanced patient age and female gender shows higher non-union rates. The second hypothesis was that primary cementless arthroplasty is associated with a higher non-union rate compared to cemented primary hip arthroplasty. METHODS: All PPFF occurring between January 2000 and June 2010 treated by revision arthroplasty were included. Multiple regression analysis was performed to identify independent variables leading to fracture non-union. RESULTS: Eighty one patients (78 % female) met the inclusion criteria. In 20/81 patients (24.7 %) no adequate fracture healing could be determined on radiographs 12 months after revision surgery. Although age and female gender showed a positive correlation with bony non-union after PPFF as expected, the p-values were not statistically significant. Multiple regression analysis revealed primary cementless prosthesis (p = 0.001) to be the only independent variable associated with non-union. CONCLUSION: Non-cemented primary prosthesis might be a negative predicting factor for the development of non-union after long-stem revision arthroplasty in PPFF. We therefore recommend the thorough debridement of pannus tissue thus inducing bone healing before the implantation of revision prostheses.
PURPOSE: In case of stem loosening in periprosthetic femoral fractures (PPFF), revision arthroplasty should be performed. The first hypothesis of this study was that advanced patient age and female gender shows higher non-union rates. The second hypothesis was that primary cementless arthroplasty is associated with a higher non-union rate compared to cemented primary hip arthroplasty. METHODS: All PPFF occurring between January 2000 and June 2010 treated by revision arthroplasty were included. Multiple regression analysis was performed to identify independent variables leading to fracture non-union. RESULTS: Eighty one patients (78 % female) met the inclusion criteria. In 20/81 patients (24.7 %) no adequate fracture healing could be determined on radiographs 12 months after revision surgery. Although age and female gender showed a positive correlation with bony non-union after PPFF as expected, the p-values were not statistically significant. Multiple regression analysis revealed primary cementless prosthesis (p = 0.001) to be the only independent variable associated with non-union. CONCLUSION: Non-cemented primary prosthesis might be a negative predicting factor for the development of non-union after long-stem revision arthroplasty in PPFF. We therefore recommend the thorough debridement of pannus tissue thus inducing bone healing before the implantation of revision prostheses.
Authors: Mark Lenz; Stephan Marcel Perren; Robert Geoff Richards; Thomas Mückley; Gunther Olaf Hofmann; Boyko Gueorguiev; Markus Windolf Journal: Int Orthop Date: 2012-11-10 Impact factor: 3.075
Authors: George Pavlou; Pavlos Panteliadis; David Macdonald; John A Timperley; Graham Gie; Gordon Bancroft; Eleftherios Tsiridis Journal: Hip Int Date: 2011 Jan-Mar Impact factor: 2.135
Authors: Clemens Gwinner; Sven Märdian; Tobias Dröge; Martin Schulze; Michael J Raschke; Richard Stange Journal: Int Orthop Date: 2015-05-07 Impact factor: 3.075