Evidence is presented, largely from clinical sources, that a large collar is not necessary for the transfer of load to the proximal femur in cemented total hip arthroplasty. In fact, the use of a collar may have a number of deleterious side effects that cannot be predicted from theoretical analyses. Concern is also raised over the use of precoated femoral stems.
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Cureus
December 2024
Orthopedic Surgery, Sengkang General Hospital, Singapore, SGP.
Background: Femoral condyle insufficiency fractures following total knee arthroplasty (FCIF-TKA) are rare but significant complications. These fractures, characterized by atraumatic bone insufficiency near the femoral component, present unique challenges in postoperative care, often necessitating femoral component revision.
Methods: This study retrospectively reviewed 835 primary total knee arthroplasties performed by a single surgeon, identifying six cases of FCIF-TKA.
J Am Acad Orthop Surg
January 2025
From the Hawaii Permanente Medical Group, Kaiser Permanente, Honolulu, HI (Okike), the Department of Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA (Prentice, Paxton, and Fasig), the San Francisco Orthopaedic Residency Program, San Francisco, CA (Shah), the Permanente Medical Group, Oakland, CA (Grimsrud), and the Washington Permanente Medical Group P.C, Seattle, WA (Chen).
Background: Cemented fixation is recommended in the hemiarthroplasty treatment of geriatric femoral neck fractures. Certain cemented stems have similarly designed "low-demand" counterparts, but it is unclear whether they yield comparable clinical outcomes. The purpose of this study was to evaluate the revision risk associated with two low-demand stems, Summit Basic (DePuy Synthes) and Versys LD/Fx (Zimmer Biomet), in comparison to their standard counterparts, Summit (DePuy Synthes) and Versys Advocate (Zimmer Biomet).
View Article and Find Full Text PDFIowa Orthop J
January 2025
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Background: Cementless stems are commonly used in hemiarthroplasty (HA) for femoral neck fractures. Recent studies have reported increased risk of periprosthetic fracture with cementless stems compared to cemented HA. In elective total hip arthroplasty (THA), lower proximal canal fill ratios (CFR) of cementless stems have been associated with worse outcomes.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Orthopaedic Surgery, The First Affiliated Hospital of Naval Medical University: Changhai Hospital, Shanghai, China.
Short-stem total hip arthroplasty (SHA) has become popular because it preserves femoral bone stock and enables the use of short femoral stems in revision total hip arthroplasty (THA). However, no study has evaluated whether a short stem in revision THA, replacing a standard stem, can provide adequate primary stability to facilitate osseous integration. In this biomechanical study, a metaphyseal anchoring SHA (Tri-Lock BPS) stem and a standard THA (Corail) stem were implanted into ten composite femurs and loaded dynamically from 300 to 1700 N with 1 Hz.
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopaedics, University of Missouri-Kansas City, Kansas City, MO (Dr. Amin, Dr. Krumme, Dr. Gause, Dr. Dubin, and Dr. Cil), and the Department of Orthopaedics, Kansas City Orthopaedic Alliance, Leawood, KS (Dr. Krumme).
Geriatric femoral neck fractures are common orthopaedic injuries, which are associated with a high morbidity and mortality. Arthroplasty is the optimum treatment for many of these injuries, but debate exists regarding optimal surgical strategy. Multiple recent investigations have demonstrated strong superiority for cemented stems as compared with noncemented fixation with a decreased risk of periprosthetic fracture, shorter length of stay, lower cost, and decreased rate for revision surgery.
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