Prevalence of Postoperative Periprosthetic Femur Fractures Between Two Different Femoral Component Designs Used in Direct Anterior Total Hip Arthroplasty.

Autor: Christensen KS; Department of Engineering, Vanderbilt University, Nashville, TN., Wicker DI; Department of Orthopaedics, Bluegrass Orthopaedics, Lexington, KY., Wight CM; Department of Regulatory Affairs, Signature Orthopaedics, Sydney, Australia., Christensen CP; Department of Orthopaedics, Bluegrass Orthopaedics, Lexington, KY.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2019 Dec; Vol. 34 (12), pp. 3074-3079. Date of Electronic Publication: 2019 Jul 04.
DOI: 10.1016/j.arth.2019.06.061
Abstrakt: Background: Periprosthetic femur fractures are a well-documented complication following direct anterior uncemented total hip arthroplasty. The purpose of this study is to compare the prevalence of postoperative periprosthetic femur fractures between 2 different femoral component designs used in direct anterior total hip arthroplasty.
Methods: Beginning in February 2015, a single fellowship-trained adult reconstruction surgeon performed 361 consecutive direct anterior total hip replacements using a flat, single-taper, wedged femoral implant. In June 2016, that same surgeon, using the exact same surgical technique and postoperative weight-bearing protocol, began using a dual-taper, hydroxyapatite-coated implant for 789 consecutive hips. The patients were carefully monitored for 3 months after surgery to identify the frequency of periprosthetic femur fractures. A Fisher's exact test was used to determine if the prevalence of periprosthetic femur fractures differed between the 2 implant designs.
Results: Five of 361 (1.4%) patients sustained proximal femur fractures at an average of 19.6 days postoperatively in the first group, all demonstrating a Vancouver type B2 periprosthetic fracture and requiring femoral revision. No patients (0/789, 0%) in the second cohort sustained a postoperative, periprosthetic fracture (P = .006).
Conclusion: In this comparison of 2 consecutive cohorts, the dual-taper, hydroxyapatite-coated implant had a statistically significant lower postoperative periprosthetic fracture rate than a flat, single-taper, wedged design.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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