Introduction A total hip replacement is a common procedure performed by trauma and orthopaedic surgeons. Successful outcomes in arthroplasty surgery have significantly contributed to more hip replacement procedures being performed annually. This has also increased the incidence of femoral periprosthetic fractures, leading to more revision hip replacement procedures being performed. Methods This is a retrospective cohort study carried out at a district general hospital in the United Kingdom. Theatre records were reviewed from 2018 to 2022 to identify patients with a femoral periprosthetic fracture. Following the data collection, the patients were split into two groups. The first group analysed the patient outcomes through the type of surgical intervention they had, and the second group analysed the patients according to the timing of surgical intervention. Results There were 88 patients included in the study, out of which 49 had revision surgery and 39 had fixation for the femoral periprosthetic fracture. No statistically significant difference was observed in 30-day mortality and one-year mortality for the patients having revision or fixation surgery. Similarly, the results were not found to be significant in 30-day mortality and one-year mortality for the patients having surgery within 36 hours or after 36 hours of diagnosis. Conclusion Overall, the findings of this study are in keeping with the literature. Input from the specialist arthroplasty team is often required for the management of femoral periprosthetic fractures. There is no significant impact on mortality with a delay in surgical intervention for femoral periprosthetic fractures, unlike hip fractures. Medical optimisation and careful planning lead to better patient outcomes for this group of patients.
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http://dx.doi.org/10.7759/cureus.74149 | DOI Listing |
J Arthroplasty
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
Introduction: The choice between cemented and cementless fixation in primary elective total hip arthroplasty (THA) remains a subject of ongoing debate. However, comparisons between the two are subject to limited adjustments for patient characteristics, diagnoses, and surgical factors, as well as by limited outcome time endpoints. Our study aimed to compare the effect of femoral fixation on safety and implant survival outcomes in matched patients.
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 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.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Adult Reconstruction and Joint Replacement Service, Division of Sports Traumatology and Joint Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, Roma, RM 00168, Italy.
Introduction: Total hip arthroplasty (THA) surgeries are rapidly increasing due to an aging population, leading to an increase in degenerative hip osteoarthritis. However, 1% of these patients go through prosthetic joint infection (PJI), which gives rise to implant failure with prolonged periods of patient incapacitation and higher mortality risk.
Case Report: In this article, we report an unusual case of a 62-year-old male who developed a PJI 7 months after a THA.
J Clin Med
December 2024
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba 305-8575, Ibaraki, Japan.
Proximal femoral fractures are particularly common in older adults, and cases requiring conversion to total hip arthroplasty may arise because of treatment failure or osteoarthritis. Fractures around the distal screw removal holes can be problematic. This study aimed to analyze the relationship between stem length and femoral stress distribution to determine the optimal stem length.
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