Skip to main content
Top
Published in: Osteoporosis International 9/2018

01-09-2018 | Original Article

Is calcium phosphate augmentation a viable option for osteoporotic hip fractures?

Authors: S.-J. Kim, H.-S. Park, D.-W. Lee, J.-W. Lee

Published in: Osteoporosis International | Issue 9/2018

Login to get access

Abstract

Summary

The use of calcium phosphate bone cement has been described to allow for retention of reduction. Therefore, we evaluated whether augmentation with resorbable calcium phosphate could improve fracture stability in osteoporotic hip fractures. The results showed that augmentation with calcium phosphate cement significantly improved the stability of intertrochanteric fractures.

Introduction

The aim with this study was to measure whether augmentation with resorbable calcium phosphate cement could improve fracture stability in osteoporotic hip fractures.

Methods

We retrospectively reviewed 82 patients who underwent closed reduction and internal fixation with proximal femoral nail (PFN) for unstable intertrochanteric fractures between 2014 and 2017. In 42 of 82 patients, patients were treated with a PFN alone (group I). These patients were compared with 40 patients for whom the same device combined with calcium phosphate cement for augmentation was used (group II). Questionnaire surveys or telephone interviews were conducted and patients completed a self-report Harris hip score (HHS) and visual analog scale (VAS) scores. Radiographic outcomes including mean sliding distance of screw, femoral shortening, and varus collapse were compared. Postoperative complications were compared.

Results

Clinical outcomes at 6 months after surgery were equivalent in both groups. Screw sliding, femoral shortening, and varus collapse were all significantly reduced in the cemented group at the last follow-up (p < 0.001, p = 0.005, p < 0.001, respectively). A total of 9 (21%) complications occurred in group I. In contrast, 2 (5%) complications were seen in group II (p = 0.029).

Conclusions

Augmentation with calcium phosphate cement significantly improved the stability of intertrochanteric fractures fixed with a PFN and reduced overall failure rates. We believe augmentation with resorbable calcium phosphate cement for osteoporotic hip fractures is a reasonable option in selected patients.
Literature
2.
go back to reference Kyle RF, Cabanela ME, Russell TA, Swiontkowski MF, Winquist RA, Zuckerman JD, Schmidt AH, Koval KJ (1995) Fractures of the proximal part of the femur. Instr Course Lect 44:227–253PubMed Kyle RF, Cabanela ME, Russell TA, Swiontkowski MF, Winquist RA, Zuckerman JD, Schmidt AH, Koval KJ (1995) Fractures of the proximal part of the femur. Instr Course Lect 44:227–253PubMed
7.
go back to reference Moroni A, Hoang-Kim A, Lio V, Giannini S (2006) Current augmentation fixation techniques for the osteoporotic patient. Scand J Surg 95(2):103–109CrossRefPubMed Moroni A, Hoang-Kim A, Lio V, Giannini S (2006) Current augmentation fixation techniques for the osteoporotic patient. Scand J Surg 95(2):103–109CrossRefPubMed
11.
12.
13.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755CrossRefPubMed Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755CrossRefPubMed
14.
go back to reference Jensen MP, Chen C, Brugger AM (2003) Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 4(7):407–414CrossRefPubMed Jensen MP, Chen C, Brugger AM (2003) Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 4(7):407–414CrossRefPubMed
16.
go back to reference Marsh D (1998) Concepts of fracture union, delayed union, and nonunion. Clin Orthop Relat Res 355S(355 Suppl):S22–S30CrossRef Marsh D (1998) Concepts of fracture union, delayed union, and nonunion. Clin Orthop Relat Res 355S(355 Suppl):S22–S30CrossRef
22.
go back to reference Goodman SB, Bauer TW, Carter D, Casteleyn PP, Goldstein SA, Kyle RF, Larsson S, Stankewich CJ, Swiontkowski MF, Tencer AF, Yetkinler DN, Poser RD (1998) Norian SRS cement augmentation in hip fracture treatment. Laboratory and initial clinical results. Clin Orthop Relat Res 348:42–50CrossRef Goodman SB, Bauer TW, Carter D, Casteleyn PP, Goldstein SA, Kyle RF, Larsson S, Stankewich CJ, Swiontkowski MF, Tencer AF, Yetkinler DN, Poser RD (1998) Norian SRS cement augmentation in hip fracture treatment. Laboratory and initial clinical results. Clin Orthop Relat Res 348:42–50CrossRef
23.
go back to reference Mattsson P, Larsson S (2004) Unstable trochanteric fractures augmented with calcium phosphate cement. A prospective randomized study using radiostereometry to measure fracture stability. Scand J Surg 93(3):223–228CrossRefPubMed Mattsson P, Larsson S (2004) Unstable trochanteric fractures augmented with calcium phosphate cement. A prospective randomized study using radiostereometry to measure fracture stability. Scand J Surg 93(3):223–228CrossRefPubMed
26.
go back to reference Kopylov P, Jonsson K, Thorngren KG, Aspenberg P (1996) Injectable calcium phosphate in the treatment of distal radial fractures. J Hand Surg Br 21(6):768–771CrossRefPubMed Kopylov P, Jonsson K, Thorngren KG, Aspenberg P (1996) Injectable calcium phosphate in the treatment of distal radial fractures. J Hand Surg Br 21(6):768–771CrossRefPubMed
27.
go back to reference Cassidy C, Jupiter JB, Cohen M, Delli-Santi M, Fennell C, Leinberry C, Husband J, Ladd A, Seitz WR, Constanz B (2003) Norian SRS cement compared with conventional fixation in distal radial fractures. A randomized study. J Bone Joint Surg Am 85-A(11):2127–2137CrossRefPubMed Cassidy C, Jupiter JB, Cohen M, Delli-Santi M, Fennell C, Leinberry C, Husband J, Ladd A, Seitz WR, Constanz B (2003) Norian SRS cement compared with conventional fixation in distal radial fractures. A randomized study. J Bone Joint Surg Am 85-A(11):2127–2137CrossRefPubMed
Metadata
Title
Is calcium phosphate augmentation a viable option for osteoporotic hip fractures?
Authors
S.-J. Kim
H.-S. Park
D.-W. Lee
J.-W. Lee
Publication date
01-09-2018
Publisher
Springer London
Published in
Osteoporosis International / Issue 9/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-018-4572-z

Other articles of this Issue 9/2018

Osteoporosis International 9/2018 Go to the issue