Polished, Collarless, Tapered, Cemented Stems for Primary Hip Arthroplasty May Exhibit High Rate of Periprosthetic Fracture at Short-Term Follow-Up
| Autor: | Anthony Salvatore, Pauline Woo, Trevor P. Scott, Yuo-yu Lee, Eduardo A. Salvati, Alejandro Gonzalez Della Valle |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Radiography Arthroplasty Replacement Hip Dentistry Periprosthetic Prosthesis Design Composite beams 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Orthopedics and Sports Medicine In patient 030212 general & internal medicine Fixation (histology) Aged Retrospective Studies High rate 030222 orthopedics business.industry Bone Cements Middle Aged Single surgeon Surgery Hip arthroplasty Female Hip Prosthesis Periprosthetic Fractures business Follow-Up Studies |
| Zdroj: | The Journal of arthroplasty. 33(4) |
| ISSN: | 1532-8406 |
| Popis: | Background Cemented stems are designed to follow 1 of 2 principles of fixation: composite beams or slide taper. Stems in the latter category have a collarless, polished, tapered (CPT) design and subside into the cement mantle, creating hoop stresses. We compared the rate of periprosthetic fracture (PPF) of stem designed with these 2 principles of fixation. In addition, we examined radiographic factors that may predispose to the development of PPF. Methods We retrospectively reviewed all patients who underwent primary THA by a single surgeon using highly polished cemented stems. PPF rates were compared between CPT stems (follow-up, 21 months; standard deviation [SD], 22) and composite beam stems (follow-up, 21.7 months; SD, 26). Demographic data were compared between patients with and without a PPF. Three preoperative radiographic parameters (canal bone ratio [CBR], canal-calcar ratio, and canal flare index), stem alignment, and cement mantle were compared in match-paired patients with and without a PPF (1:34). Results Seven of 1460 THA patients developed a PPF (0.479%); 4 hips of 185 with a CPT stem (2.2%); and 3 of 1275 hips with a composite beam stem (0.23%; P = .0064). Three of the 4 PPFs in the CPT group and none in the composite beam group were classified as Vancouver B2. The CBR in patients with a PPF was 0.50 (SD, 0.07) and 0.43 (SD, 0.07) in the match cohort of hips without PPF (P = .013). Conclusion CPT stems may be associated with a higher risk of PPF that often require reoperation. An increased CBR may be a risk factor for postoperative PPF. |
| Databáze: | OpenAIRE |
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