Impact of intraoperative femoral fractures in primary hip arthroplasty: a comparative study with a mid-term follow-up.


Journal

Hip international : the journal of clinical and experimental research on hip pathology and therapy
ISSN: 1724-6067
Titre abrégé: Hip Int
Pays: United States
ID NLM: 9200413

Informations de publication

Date de publication:
Sep 2020
Historique:
pubmed: 18 5 2019
medline: 28 1 2021
entrez: 18 5 2019
Statut: ppublish

Résumé

Intraoperative femoral fractures (IFF) during primary total hip arthroplasty (THA) pose a major clinical challenge, and data on mid-term implant performance, functional outcome and patient satisfaction is limited. 50 patients who sustained IFFs during primary THA were retrospectively reviewed. A control group of patients who received a primary THA without complications was matched according to gender, age, body mass index and indication for THA. Both groups were followed-up for a minimum duration of 2 years. Average follow-up duration was 5.6 years (range 2-11.8 years) for the fracture group and 6 years (range 4.1-8.3 years) for the control group respectively. The following parameters were assessed and compared: stem revision, Harris Hip Score improvement, pain scale improvement, WOMAC, Tegner Score, UCLA, SF-36, forgotten joint score and patient satisfaction. There were no stem revisions in the fracture group and 1 stem revision in the control group. Stem survival was 100% and 98.1% respectively ( Intraoperative fractures of the proximal femur are a relevant complication that does not lead to higher revision rates but might worsen the functional outcome and negatively impact patient satisfaction in mid-term follow-up even if treated appropriately.

Sections du résumé

BACKGROUND BACKGROUND
Intraoperative femoral fractures (IFF) during primary total hip arthroplasty (THA) pose a major clinical challenge, and data on mid-term implant performance, functional outcome and patient satisfaction is limited.
METHODS METHODS
50 patients who sustained IFFs during primary THA were retrospectively reviewed. A control group of patients who received a primary THA without complications was matched according to gender, age, body mass index and indication for THA. Both groups were followed-up for a minimum duration of 2 years. Average follow-up duration was 5.6 years (range 2-11.8 years) for the fracture group and 6 years (range 4.1-8.3 years) for the control group respectively. The following parameters were assessed and compared: stem revision, Harris Hip Score improvement, pain scale improvement, WOMAC, Tegner Score, UCLA, SF-36, forgotten joint score and patient satisfaction.
RESULTS RESULTS
There were no stem revisions in the fracture group and 1 stem revision in the control group. Stem survival was 100% and 98.1% respectively (
CONCLUSION CONCLUSIONS
Intraoperative fractures of the proximal femur are a relevant complication that does not lead to higher revision rates but might worsen the functional outcome and negatively impact patient satisfaction in mid-term follow-up even if treated appropriately.

Identifiants

pubmed: 31096789
doi: 10.1177/1120700019849911
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

544-551

Auteurs

Thomas Ferbert (T)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

Ayham Jaber (A)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

Nathan Gress (N)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

Gerhard Schmidmaier (G)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

Tobias Gotterbarm (T)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

Christian Merle (C)

Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

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Classifications MeSH