Sang-Min Kim1, Seung-Beom Han2, Kee Hyung Rhyu3, Jeong Joon Yoo4, Kwang-Jun Oh5, Je Hyun Yoo6, Kyung-Jae Lee7, Seung-Jae Lim8. 1. Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University School of Medicine, Seoul, South Korea. 2. Department of Orthopedic Surgery, College of Medicine, Anam Hospital, Korea University, Seoul, South Korea. 3. Department of Orthopedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Kyung-Hee University, Seoul, South Korea. 4. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea. 5. Department of Orthopedic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, South Korea. 6. Department of Orthopedic Surgery, Hallym University Sacred Heart hospital, Anyang, South Korea. 7. Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea. 8. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, South Korea. limsj70@gmail.com.
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.
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.
Entities:
Keywords:
Hip replacement; Periprosthetic femoral fracture; Reoperation; Short stem
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