Femoral stem fractures after primary and revision hip replacements: A single-center experience
| Autor: | Alper Köksal, Yalkin Camurcu, Ali Öner, Hakan Akgün, Osman Çimen, Osman Emre Aycan, Furkan Yapici |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Arthroplasty Replacement Hip Radiography Revision hip replacement Femoral stem Prosthesis Design Single Center Risk Factors Humans Medicine Orthopedics and Sports Medicine Device Removal Aged Retrospective Studies Aged 80 and over stem fracture business.industry Rehabilitation Retrospective cohort study Mean age Middle Aged total hip arthroplasty Osteotomy Prosthesis Failure Surgery stem revision Trochanteric osteotomy Original Article Female Extraction methods Hip Prosthesis business |
| Zdroj: | Joint Diseases and Related Surgery |
| ISSN: | 2687-4792 2687-4784 |
| Popis: | Objectives This study aims to present our experience in the management of fractured femoral stems after primary and revision hip replacements by evaluating the clinical and radiographic characteristics and determining the effectiveness of the extraction methods. Patients and methods A total of 15 patients (5 males, 10 females; mean age 65.9 years; range, 49 to 87 years) who underwent revision hip replacement due to a fractured femoral stem between January 2005 and December 2019 were included in this retrospective study. The mechanisms and risk factors for failure as well as methods applied to extract fractured stem were analyzed through clinical and radiographic data. Results Nine patients had fractured cemented femoral stems, while six patients had fractured fully porous coated cementless revision stems. Lack of proximal buttress in distally fixed femoral stems was detected in 11 patients and identified as the predominant mechanism resulting in fracture. The proximal extraction method with conventional revision instrumentation, the cortical window technique, and extended trochanteric osteotomy (ETO) were used in three, seven, and five cases, respectively. Conclusion Our results demonstrated that the lack of proximal buttress is the most common reason for femoral stem fracture. Moreover, the proximal extraction method was mostly ineffective in fully porous femoral stems. A step-by-step approach should be considered for the extraction of a broken stem. The cortical window method can be considered as the second step if proximal extraction methods fail, and ETO should be considered at the last step if all techniques fail. |
| Databáze: | OpenAIRE |
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