Melissa Laflamme1, Michèle Angers1, Jessica Vachon2, Veronica Pomerleau3, Annie Arteau4. 1. Department of Orthopaedic Surgery, CHU de Québec - Centre Hospitalier de l'Université Laval (CHUL), Québec City, Québec, Canada. 2. Department of Orthopaedic Surgery, Hôtel-Dieu-de-Lévis, Lévis, Québec, Canada. 3. Department of Surgery, Faculté de Médecine, Université Laval, Québec City, Québec, Canada. 4. Department of Orthopaedic Surgery, CHU de Québec - Hôtel-Dieu-de-Québec, Québec, Québec, Canada.
Abstract
BACKGROUND: To reduce costs of orthopedic implants, the government decided to standardize implants used across different specialties in a group of hospitals located in the same geographic area. The usual cemented stem used in the context of intracapsular displaced geriatric hip fractures was replaced by another stem. Abnormal intraoperative calcar and trochanteric fractures were noted. The purpose of this study is to determine the incidence of intraoperative periprosthetic fractures following an intracapsular displaced hip fracture treated with this specific cemented stem compared to the previous implant. METHODS: This is a retrospective cohort study comparing an historic cohort of hip fractures treated with the OmniFit EON (Stryker, Kalamazoo, MI) cemented stem with a new cohort of patients who received the Corail (DePuy Synthes, Warsaw, IN) cemented stem. Four orthopedic surgeons reviewed operative reports and postoperative radiographs. RESULTS: The treatment group included 348 patients who received the Corail stem. The control group included 77 patients. The 2 groups had similar baseline characteristics (P > .05) except for the presence of dementia. Incidence of intraoperative calcar or greater trochanteric fracture was 15.5% for the Corail group and 2.7% for the control group (P < .05). No patient-related factors or surgeon-related factors were related to a higher number of fractures in the treatment group (P > .05). CONCLUSION: The Corail cemented stem presents an abnormal number of iatrogenic intraoperative fractures following displaced femoral neck fracture in our geriatric population. No external factor seems to explain this high number of fractures. Implant design should be questioned. LEVEL OF EVIDENCE: III.
BACKGROUND: To reduce costs of orthopedic implants, the government decided to standardize implants used across different specialties in a group of hospitals located in the same geographic area. The usual cemented stem used in the context of intracapsular displaced geriatric hip fractures was replaced by another stem. Abnormal intraoperative calcar and trochanteric fractures were noted. The purpose of this study is to determine the incidence of intraoperative periprosthetic fractures following an intracapsular displaced hip fracture treated with this specific cemented stem compared to the previous implant. METHODS: This is a retrospective cohort study comparing an historic cohort of hip fractures treated with the OmniFit EON (Stryker, Kalamazoo, MI) cemented stem with a new cohort of patients who received the Corail (DePuy Synthes, Warsaw, IN) cemented stem. Four orthopedic surgeons reviewed operative reports and postoperative radiographs. RESULTS: The treatment group included 348 patients who received the Corail stem. The control group included 77 patients. The 2 groups had similar baseline characteristics (P > .05) except for the presence of dementia. Incidence of intraoperative calcar or greater trochanteric fracture was 15.5% for the Corail group and 2.7% for the control group (P < .05). No patient-related factors or surgeon-related factors were related to a higher number of fractures in the treatment group (P > .05). CONCLUSION: The Corail cemented stem presents an abnormal number of iatrogenic intraoperative fractures following displaced femoral neck fracture in our geriatric population. No external factor seems to explain this high number of fractures. Implant design should be questioned. LEVEL OF EVIDENCE: III.
Authors: Taranjit Tung; Trevor C Gascoyne; Elly Trepman; Carole H Stipelman; Sarah Tran; Eric R Bohm; Colin D Burnell; David R Hedden; Thomas R Turgeon Journal: Can J Surg Date: 2022-08-12 Impact factor: 2.840
Authors: Johannes Karl Maria Fakler; Markus Rositzka; Nicolas Schopow; Andreas Roth; Dirk Zajonz; Mohamed Ghanem; Christian Kleber; Georg Osterhoff Journal: Eur J Trauma Emerg Surg Date: 2022-03-30 Impact factor: 2.374
Authors: Johannes Karl Maria Fakler; Alexander Brand; Christian Lycke; Christina Pempe; Mohamed Ghanem; Andreas Roth; Georg Osterhoff; Ulrich Josef Albert Spiegl; Andreas Höch; Dirk Zajonz Journal: Eur J Trauma Emerg Surg Date: 2020-12-11 Impact factor: 2.374