José Antonio Valle Cruz1, Antonio Luis Urda2, Laura Serrano1, Francisco Alberto Rodriguez-Gonzalez1, Julio Otero1, Enrique Moro1, Luis López-Durán3. 1. Department of Orthopaedics & Traumatology, Hospital Clínico San Carlos, C. Prof. Martin Lagos s/n, 28040, Madrid, Spain. 2. Department of Orthopaedics & Traumatology, Hospital Clínico San Carlos, C. Prof. Martin Lagos s/n, 28040, Madrid, Spain. urda.antonio@gmail.com. 3. Department of Orthopaedics & Traumatology, Hospital Clínico San Carlos, Universidad Complutense Madrid, Madrid, Spain.
Abstract
PURPOSE: The purpose of this study was to analyse the incidence of interprosthetic femoral fractures and describe risk factors for them. METHODS: Between 2009 and 2015, we selected patients who were carrying two implants (hip and knee) in the same femur. We collected demographic and clinical data and performed a radiological evaluation to analyse the gap between implants-the femoral canal area and total femoral area-in the axial plane. We defined interprosthetic fracture as that corresponding to a Vancouver type C fracture and types 1 and 2 according to the Su classification. RESULTS: We studied 68 patients who had total knee arthroplasty (TKA), and 44 patients who had total hip arthroplasty (THA); 24 patients an intramedullary nail. We found six interprosthetic fractures (8.8 %), all in patients with a non-cemented THA. There was a tendency towards statistical difference (p = 0.08). Patients with an additional implant at the proximal femur were statistically less likely to have an interprosthetic fracture (p = 0.04). In radiological results, we found more interprosthetic fractures in patients who had an increased femoral canal area in the axial plane just distal to the tip of the hip implant. CONCLUSIONS: Identifying risk factors for this specific type of fracture may facilitate their prevention. Better implant stability and the presence of a gap between stems in a lower canal zone appear to hinder the occurrence of interprosthetic fractures.
PURPOSE: The purpose of this study was to analyse the incidence of interprosthetic femoral fractures and describe risk factors for them. METHODS: Between 2009 and 2015, we selected patients who were carrying two implants (hip and knee) in the same femur. We collected demographic and clinical data and performed a radiological evaluation to analyse the gap between implants-the femoral canal area and total femoral area-in the axial plane. We defined interprosthetic fracture as that corresponding to a Vancouver type C fracture and types 1 and 2 according to the Su classification. RESULTS: We studied 68 patients who had total knee arthroplasty (TKA), and 44 patients who had total hip arthroplasty (THA); 24 patients an intramedullary nail. We found six interprosthetic fractures (8.8 %), all in patients with a non-cemented THA. There was a tendency towards statistical difference (p = 0.08). Patients with an additional implant at the proximal femur were statistically less likely to have an interprosthetic fracture (p = 0.04). In radiological results, we found more interprosthetic fractures in patients who had an increased femoral canal area in the axial plane just distal to the tip of the hip implant. CONCLUSIONS: Identifying risk factors for this specific type of fracture may facilitate their prevention. Better implant stability and the presence of a gap between stems in a lower canal zone appear to hinder the occurrence of interprosthetic fractures.
Authors: Christiaan N Mamczak; Michael J Gardner; Brett Bolhofner; Joseph Borrelli; Philipp N Streubel; William M Ricci Journal: J Orthop Trauma Date: 2010-12 Impact factor: 2.512
Authors: Alexander P Sah; Amanda Marshall; Walter V Virkus; Daniel M Estok; Craig J Della Valle Journal: J Arthroplasty Date: 2008-12-03 Impact factor: 4.757