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Acute femoral fracture does not compromise the outcome of total hip arthroplasty : 5 year results from a single center cohort study in 2,782 patients / Stefan B.T. Bolder in Acta Orthopaedica Belgica, Vol.87/2 (Juin 2021)
[article]
Titre : Acute femoral fracture does not compromise the outcome of total hip arthroplasty : 5 year results from a single center cohort study in 2,782 patients Type de document : texte imprimé Auteurs : Stefan B.T. Bolder ; Elsa A. Spaans ; Joost A.A.M. Van Den Hout ; Robert Wagenmakers ; Keon L.M. Koenraadt Année de publication : 2021 Article en page(s) : p. 332-338 Note générale : https://doi.org/10.52628/87.2.19 Langues : Anglais (eng) Mots-clés : hip arthroplasty femoral neck fracture osteoarthritis Résumé : National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may con- tain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years.
We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group : n=2610) or acute femoral fracture (Fracture group : n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups.
Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI :0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38).
We found no difference in outcome or reason for revision between THA for OA or femoral neck frac- ture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.Permalink : ./index.php?lvl=notice_display&id=96669
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 332-338[article] Acute femoral fracture does not compromise the outcome of total hip arthroplasty : 5 year results from a single center cohort study in 2,782 patients [texte imprimé] / Stefan B.T. Bolder ; Elsa A. Spaans ; Joost A.A.M. Van Den Hout ; Robert Wagenmakers ; Keon L.M. Koenraadt . - 2021 . - p. 332-338.
https://doi.org/10.52628/87.2.19
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 332-338
Mots-clés : hip arthroplasty femoral neck fracture osteoarthritis Résumé : National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may con- tain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years.
We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group : n=2610) or acute femoral fracture (Fracture group : n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups.
Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI :0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38).
We found no difference in outcome or reason for revision between THA for OA or femoral neck frac- ture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.Permalink : ./index.php?lvl=notice_display&id=96669 Exemplaires (1)
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Exclu du prêtUltra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years / Marian Melisik in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Ultra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years Type de document : texte imprimé Auteurs : Marian Melisik ; Maros Hrubina ; Matej Daniel Année de publication : 2021 Article en page(s) : p. 619-627 Note générale : https://doi.org/10.52628/87.4.06 Langues : Anglais (eng) Mots-clés : total hip arthroplasty femoral neck fracture ultra-short anatomical cementless stem Résumé : The aim of this study was to present the midterm results of total hip arthroplasty with ultra-short anatomical cementless stem in the primary treatment of displaced intracapsular femoral neck fractures in patients younger 60 years.
From 2006 to 2015, 17 hip arthroplasties (with the Proxima stem) were performed in group of 17 patients for the treatment of acute femoral neck fractures Garden type III and IV. The mean follow-up period was 112.7 (range: 64-148) months. Patients were evaluated retrospectively - clinically and radiographically, using the Harris hip scoring system during the year 2020. Seven males and ten females (mean age: 45.0 years) were included in the study. Each of them had one or more risk factors (time delay, comminution of the femoral neck, corticosteroids usage, the presence of coxarthrosis, rheumatoid arthritis, alcohol abuse, etc…), because of which the osteosynthesis was not performed. Harris hip scores were 6.3 preoperatively and 82.9 at the final follow-up.
Three patients (17.6%) had complications: luxation, aseptic stem loosening (migration with subsidence - “varisation” and thigh pain) and deep infection. One patient (5.9%) with infection was revised.
In carefully selected younger patients with displaced intracapsular femoral neck fracture, where the osteosynthesis as first treatment option should be associated with high risk of complication (avascular femoral head necrosis, non-union) due to the presence of risk factors, the primary total hip arthroplasty could be performed. The ultra-short cementless stem offers promising results in these rare cases in the midterm.Permalink : ./index.php?lvl=notice_display&id=102011
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 619-627[article] Ultra-short cementless anatomical stem for intracapsular femoral neck fractures in patients younger than 60 years [texte imprimé] / Marian Melisik ; Maros Hrubina ; Matej Daniel . - 2021 . - p. 619-627.
https://doi.org/10.52628/87.4.06
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 619-627
Mots-clés : total hip arthroplasty femoral neck fracture ultra-short anatomical cementless stem Résumé : The aim of this study was to present the midterm results of total hip arthroplasty with ultra-short anatomical cementless stem in the primary treatment of displaced intracapsular femoral neck fractures in patients younger 60 years.
From 2006 to 2015, 17 hip arthroplasties (with the Proxima stem) were performed in group of 17 patients for the treatment of acute femoral neck fractures Garden type III and IV. The mean follow-up period was 112.7 (range: 64-148) months. Patients were evaluated retrospectively - clinically and radiographically, using the Harris hip scoring system during the year 2020. Seven males and ten females (mean age: 45.0 years) were included in the study. Each of them had one or more risk factors (time delay, comminution of the femoral neck, corticosteroids usage, the presence of coxarthrosis, rheumatoid arthritis, alcohol abuse, etc…), because of which the osteosynthesis was not performed. Harris hip scores were 6.3 preoperatively and 82.9 at the final follow-up.
Three patients (17.6%) had complications: luxation, aseptic stem loosening (migration with subsidence - “varisation” and thigh pain) and deep infection. One patient (5.9%) with infection was revised.
In carefully selected younger patients with displaced intracapsular femoral neck fracture, where the osteosynthesis as first treatment option should be associated with high risk of complication (avascular femoral head necrosis, non-union) due to the presence of risk factors, the primary total hip arthroplasty could be performed. The ultra-short cementless stem offers promising results in these rare cases in the midterm.Permalink : ./index.php?lvl=notice_display&id=102011 Réservation
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