Hip international : the journal of clinical and experimental research on hip pathology and therapy
-
Hemiarthroplasty is the preferred treatment for displaced femoral neck fractures in elderly patients. Recently, short tapered-wedge cementless stems have increasingly been used in this population. However, historic data has consistently shown higher rates of periprosthetic fracture with uncemented stems in hip fracture patients. This study aims to evaluate the rate of periprosthetic fracture requiring re-operation and all-cause mortality between cemented and uncemented femoral stem designs including more recent short tapered-wedge cementless stems in hip fracture patients. ⋯ Compared to modern uncemented femoral stem designs, cemented stems yield lower rates of periprosthetic fracture requiring re-operation, without increasing risk of all-cause mortality. Tapered-wedge stems had similar rates of re-operation due to periprosthetic fracture as reamed uncemented stems.
-
The objective was to evaluate clinical and radiological outcomes of Vancouver B2 and B3 periprosthetic femoral fractures in patients older than 65 years treated at our institution from 2000 to 2014. We compared the most common methods of fixation: a modular tapered rectangular titanium stem versus a monoblock tapered stem. ⋯ Although we reported good results of fracture healing, there were functional impairment and a high rate of complications, especially dislocation, in Vancouver B2 and B3 periprosthetic fractures in elderly patients.
-
The objective of this study was to evaluate the mid-term migration pattern of a femoral short stem. ⋯ In summary, even in the group of stems with more pronounced early subsidence, delayed settling occurred in all cases. The determination of a threshold of critical early femoral short stem subsidence is necessary because of the differing migration pattern described in this study with delayed settling of the Fitmore stem 2 years postoperatively compared to early settling within the first postoperative year described for conventional stems.
-
There has been a trend in the evolution of total hip arthroplasty towards increased modularity; with this increase in modularity come some potentially harmful consequences. Modularity at the neck shaft junction has been linked to corrosion, adverse reaction to metal debris and pseudotumour formation. ⋯ These results suggest that retention of PE liners may be reasonable when performing isolated revision of the femoral component in cases of failure at the modular neck stem junction, especially when the inner diameter of the liner is already optimised for head size and stability.
-
Modular reconstruction systems based on trabecular metal (TM) prosthetic components have been increasingly used in the last decade for the management of severe acetabular bone defects. The aim of this study was to assess the clinical and radiographic outcomes of double-cup technique for the management of Paprosky type III defects without pelvic discontinuity. ⋯ The double-cup technique could be considered an effective management of selected Paprosky type III defects without pelvic discontinuity providing excellent clinical and radiographic outcomes in the short term.