Perioperative Femur Fractures in muscle sparing anterolateral - Modified Watson-Jones approach to primary total hip arthroplasty: A retrospective cohort study.

Autor: Van Roekel N; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA., Lutnick E; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA., Pavlesen S; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA., Henry M; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA., Haider MN; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA., Phillips M; Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA.
Jazyk: angličtina
Zdroj: Journal of clinical orthopaedics and trauma [J Clin Orthop Trauma] 2024 Nov 16; Vol. 59, pp. 102828. Date of Electronic Publication: 2024 Nov 16 (Print Publication: 2024).
DOI: 10.1016/j.jcot.2024.102828
Abstrakt: Background: Periprosthetic femur fractures (PFF) are a rare early complication in primary total hip arthroplasty (THA) that may result in revision and burden the healthcare system. A previous study identified a PFF rate of 8.3 % at 90 days with the modified anterolateral Watson-Jones (AL) approach to THA. This study assesses the PFF rate and risk factors with this approach at 90 days and 1-year post-operative follow-up.
Methods: 580 primary THAs performed using the AL approach were retrospectively reviewed for risk factors associated with perioperative PFF including demographics, intra-operative and postoperative factors, and disposition.
Results: 507 included patients had a 90-day PFF rate of 1.6 % (n = 8): 6 intraoperative (1.2 %), and 2 postoperative (0.4 %), significantly lower than previously reported ( p  < 0.001). 1 additional postoperative PFF fracture was operatively managed with open reduction internal fixation (ORIF) on day 302; 1-year PFF rate was 2.5 %. All fractures healed uneventfully after treatment. The 1-year return to operating room rate for PFF was 0.3 %. Patients with PFF were significantly older (p = 0.036) compared to non-PFF patients. Implant type significantly predicted PFF.
Conclusion: The rarity of PFF among our cohort highlights the efficacy of the AL approach to avoid this complication.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MP has been reimbursed by Stryker, Smith & Nephew, and Ampio Pharmaceuticals for consulting; he has shares in Smith & Nephew and Ampio Pharmaceuticals; he has received institutional research support from Stryker Orthopedics. The remainder of the authors declare that they have no competing interests.
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Databáze: MEDLINE
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