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European Journal of Orthopaedic Surgery & Traumatology

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11-03-2024 | Hip-TEP | Original Article

Periprosthetic fracture following arthroplasty for femoral neck fracture: is a cemented stem protective?

Authors: Garrett W. Esper, Ariana T. Meltzer-Bruhn, Utkarsh Anil, Ran Schwarzkopf, William Macaulay, Sanjit R. Konda, Abhishek Ganta, Kenneth A. Egol

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2024

Abstract

Background

Periprosthetic femoral fractures (PFF) carry significant morbidity following arthroplasty for femoral neck fracture (FNF). This study assessed fracture complications following arthroplasty for FNF and the effect of cement fixation of the femoral component on intraoperative and post-operative PFF.

Methods

Between February 2014 and September 2021, 740 patients with a FNF who underwent arthroplasty were analyzed for demographics, surgical management, use of cement for fixation of the femoral component, and subsequent PFF. Variables were compared with Mann–Whitney or Chi-square as appropriate. Multivariate logistic regression was used to assess independent risk factors associated with intraoperative or post-operative PFF.

Results

There were 163 THAs (41% cemented) and 577 HAs (95% cemented). There were 28 PFFs (3.8%): 18 post-operative and 10 intraoperative. Fewer post-operative PFFs occurred with cemented stems (1.63% vs. 6.30%, p = 0.002). Mean time from surgery to presentation with post-operative PFF was 14 months (0–45 months). Mean follow-up time was 10.3 months (range: 0–75.7 months). In multivariate regression, use of cement and THA was independently associated with decreased post-operative PFF (cement: OR 0.112, 95% CI 0.036–0.352, p < 0.001 and THA: OR 0.249, 95% CI 0.064–0.961, p = 0.044). More intraoperative fractures occurred during THA (3.68% vs. 0.69%, p = 0.004) and non-cemented procedures (5.51% vs. 0.49%, p < 0.001). In multivariate regression, use of cement was protective against intraoperative fracture (OR 0.100, CI 0.017–0.571, p = 0.010).

Conclusions

In patients with a FNF treated with arthroplasty, cementing the femoral component is associated with a lower risk of intraoperative and post-operative PFF. Choice of procedure may be based on patient factors and surgeon preference.

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Title: Periprosthetic fracture following arthroplasty for femoral neck fracture: is a cemented stem protective?
Authors: Garrett W. Esper
Ariana T. Meltzer-Bruhn
Utkarsh Anil
Ran Schwarzkopf
William Macaulay
Sanjit R. Konda
Abhishek Ganta
Kenneth A. Egol
Publication date: 11-03-2024
Publisher: Springer Paris
Keywords: Hip-TEP
Hip-TEP
Periprosthetic Fracture
Femoral Fracture
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03830-5

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Periprosthetic fracture following arthroplasty for femoral neck fracture: is a cemented stem protective?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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