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International Orthopaedics

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01-09-2015 | Original Paper

High incidence of stem loosening in association with periprosthetic femur fractures in previously well-fixed cementless grit-blasted tapered-wedge stems

Authors: Seung-Jae Lim, Kyung-Jae Lee, Byung-Woo Min, Joo-Hyoun Song, Sang-Yeon So, Youn-Soo Park

Published in: International Orthopaedics | Issue 9/2015

Abstract

Purpose

Periprosthetic femur fracture is a potentially worrisome phenomenon for cementless stem fixation. The aim of this study was to document the incidence of stem loosening following periprosthetic femur fracture in previously well-fixed cementless grit-blasted tapered-wedge stems.

Methods

We identified 36 periprosthetic femur fractures of either Vancouver B1 or B2 following hip arthroplasties using cementless grit-blasted tapered-wedge titanium stems at three participating institutions (GB group). The control group consisted of 21 periprosthetic femur fractures of either Vancouver B1 or B2 following hip arthroplasties using cementless proximal porous-coated stems at the same institutions during the same period of study (PC group). All femoral stems had been in a well-fixed state before occurrence of fracture. All patients were treated surgically and femoral stem stability was assessed using preoperative radiographs and confirmed by intraoperative scrutinization.

Results

Seven (19.4 %) of 36 fractures were Vancouver B1 and 29 (80.6 %) were Vancouver B2 in the GB group, whereas 18 (85.7 %) of 21 fractures were Vancouver B1 and 3 (14.3 %) were Vancouver B2 in the PC group (P < 0.0001). The odds ratio for stem loosening was 24.86 (95 % CI, 5.69–108.63) in the GB group versus the PC group.

Conclusions

Hip arthroplasty using cementless grit-blasted tapered-wedge titanium stems showed higher incidence of stem loosening in association with periprosthetic femur fracture than hip arthroplasty conducted using proximal porous-coated stems. A high index of suspicion of stem loosening might be necessary in periprosthetic femur fracture following hip arthroplasty using this type of stems.

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Title: High incidence of stem loosening in association with periprosthetic femur fractures in previously well-fixed cementless grit-blasted tapered-wedge stems
Authors: Seung-Jae Lim
Kyung-Jae Lee
Byung-Woo Min
Joo-Hyoun Song
Sang-Yeon So
Youn-Soo Park
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2586-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High incidence of stem loosening in association with periprosthetic femur fractures in previously well-fixed cementless grit-blasted tapered-wedge stems

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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