Low risk of periprosthetic fracture and subsidence with automated impaction device in arthroplasty following femoral neck fracture: A retrospective study

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-05-20 DOI:10.1016/j.jor.2025.05.036

Courtney Levit , Ryan Decook , Joseph M. Schwab , Thomas L. Bradbury , Natalie L. Gresham , Anita “Alex” Bradham , Farideh Najafi , Brandon Naylor

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引用次数: 0

Abstract

Background

Manual broaching in hip arthroplasty for femoral neck fractures (FNFx) may introduce variability in force application, increasing the risk of periprosthetic fractures. Automated impaction devices (AID) deliver consistent, uniform force vectors during femoral preparation, potentially reducing implant-bone mismatch, stem subsidence, and fracture risk. This study evaluates early complication rates following AID use in hip arthroplasty for FNFx.

Methods

A retrospective cohort study was conducted on consecutive patients undergoing total hip arthroplasty (THA) or hemiarthroplasty (HA) for FNFx by two surgeons between January 1, 2019, and June 1, 2023. All patients received a cementless femoral stem implanted with an AID and had a minimum 30-day follow-up. Outcomes assessed included 30-day revision-free stem survivorship, intraoperative and postoperative periprosthetic fractures, femoral component subsidence, and 30-day reoperation and readmission rates.

Results

The cohort included 118 patients [72.0 % women; mean age 77.4 (range, 52–95) years], with 82 (69.5 %) undergoing THA and 36 (30.5 %) HA. One intraoperative fracture (0.8 %, Vancouver AG) and one postoperative fracture (0.8 %, Vancouver B1) occurred. The 30-day reoperation rate was 3.4 % (n = 4), and the readmission rate was 16.3 % (n = 15). Mild femoral component subsidence occurred in 1.7 % (n = 2) without evidence of loosening. No femoral stem revisions were reported within 30 days, yielding a 100 % short-term survivorship rate.

Conclusion

Early outcomes suggest that AID use in hip arthroplasty for FNFx is associated with low rates of periprosthetic fracture, subsidence, and early complications. Further prospective studies are needed to assess long-term outcomes.

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股骨颈骨折后关节置换术中使用自动内压装置降低假体周围骨折和下沉的风险：一项回顾性研究

背景：股骨颈骨折（FNFx）人工髋关节置换术中人工拉削可能会导致力量施加的变化，增加假体周围骨折的风险。在股骨准备过程中，自动内嵌装置（AID）提供一致、均匀的力矢量，潜在地减少了植入物骨不匹配、椎体下沉和骨折风险。本研究评估了在髋关节置换术中使用AID治疗FNFx后的早期并发症发生率。方法对2019年1月1日至2023年6月1日期间由两名外科医生连续接受全髋关节置换术（THA）或半髋关节置换术（HA）治疗FNFx的患者进行回顾性队列研究。所有患者均接受植入AID的无水泥股骨干，并进行至少30天的随访。评估的结果包括30天无修复手术的患者存活、术中和术后假体周围骨折、股骨假体沉降、30天再手术和再入院率。结果纳入118例患者，其中女性占72.0%；平均年龄77.4岁（52-95岁），其中82例（69.5%）行THA， 36例（30.5%）行HA。术中骨折1例（0.8%,Vancouver AG），术后骨折1例（0.8%,Vancouver B1）。30天再手术率为3.4% (n = 4)，再入院率为16.3% （n = 15）。1.7% （n = 2）发生轻度股骨假体下沉，无松动迹象。30天内没有股骨干修复的报道，短期生存率为100%。结论：早期结果表明，在FNFx髋关节置换术中使用AID可降低假体周围骨折、下沉和早期并发症的发生率。需要进一步的前瞻性研究来评估长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.