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International Orthopaedics
Published in: International Orthopaedics 8/2016

01-08-2016 | Original Paper

Cementless total hip arthroplasty for patients previously treated with femoral osteotomy for hip dysplasia: the incidence of periprosthetic fracture

Authors: Masanobu Ohishi, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Jun-ichi Fukushi, Satoshi Hamai, Yusuke Kohno, Yukihide Iwamoto

Published in: International Orthopaedics | Issue 8/2016

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Abstract

Purpose

Femur deformities can make stem fixation difficult in total hip arthroplasty (THA). We report the clinical results of cementless THA using a press-fit stem in patients who had previously undergone femoral osteotomy for hip dysplasia.

Methods

The subjects included 66 hips in 64 patients, with the mean follow-up period of 7.3 years. THA was performed at a mean period of 17.1 years after intertrochanteric femoral osteotomy. Valgus osteotomy was performed in 42 hips, and varus osteotomy in 24. Clinical results were evaluated by using the Merle d’Aubigne-Postel score. Implant survival was determined with revision as the end point, and any related complications were investigated.

Results

The Merle d’Aubigne-Postel score improved from 9.4 to 16.1 at the final follow-up, without any implant loosening. However, periprosthetic femoral fractures were observed in four hips (6.0 %), one intra-operatively and three within three weeks after THA. Among these cases, three hips previously had varus osteotomy (12.5 %) and one hip had valgus osteotomy (2.3 %). Two hips were revised with full porous stems and circumferential wiring. The five and ten year cumulative survivorship rates were 97 % (range, 88.8–99.3 %) and 97 % (88.8–99.3 %), respectively.

Conclusions

Although the use of a press-fit cementless stem yielded acceptable results in most of the patients, perioperative femoral fracture was a major complication especially in the patients previously treated with intertrochanteric varus osteotomy. Careful planning and implant selection could be emphasized for these cases.
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Metadata
Title
Cementless total hip arthroplasty for patients previously treated with femoral osteotomy for hip dysplasia: the incidence of periprosthetic fracture
Authors
Masanobu Ohishi
Yasuharu Nakashima
Takuaki Yamamoto
Goro Motomura
Jun-ichi Fukushi
Satoshi Hamai
Yusuke Kohno
Yukihide Iwamoto
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2992-3

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