Collared fully hydroxyapatite-coated stem decreases the risk of early postoperative periprosthetic femoral fracture after direct anterior total hip arthroplasty

Journal of Joint Surgery and Research Pub Date : 2023-12-01 DOI:10.1016/j.jjoisr.2023.05.002

Tatsuya Tamaki , Tetsuya Kimura , Yoko Miura , Kazuhiro Oinuma

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Abstract

Purpose

Postoperative periprosthetic femoral fracture (PPFF) is one of the major complications following total hip arthroplasty (THA). The purpose of this study was to investigate the epidemiology of early PPFF (within 90 days) after THA.

Methods

Primary THA was performed for hip osteoarthritis through a direct anterior approach in 6769 cases. Among these, we retrospectively investigated the occurrence of postoperative PPFF that required surgical intervention.

Results

Postoperative PPFF was seen in 29 hips (29/6769; 0.43%), and the mean period from primary THA to fracture occurrence was 9.2 ± 8.5 days. Of these, 13 (13/2170; 0.60%) fractures were observed in prosthesis with flat tapered-wedge stems, 7 (7/1652; 0.42%) in straight tapered stems, 4 (4/1082; 0.37%) in cemented stems, and 1 (1/1.060; 0.09%) in collared fully hydroxyapatite-coated stem. The prevalence of PPFF in collared fully hydroxyapatite-coated stems was significantly lower than that of flat tapered-wedge stems. Five hips (5/29; 17.2%) required re-surgical intervention.

Conclusion

Our results indicate that, compared to the flat tapered-wedge stem, use of the collared fully hydroxyapatite-coated stem decreases the risk of early postoperative PPFF following direct anterior THA.

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人工全髋关节置换术后早期发生假体周围骨折的风险

目的人工髋关节置换术后股骨假体周围骨折（PPFF）是全髋关节置换术（THA）的主要并发症之一。本研究的目的是调查THA术后90天内早期PPFF的流行病学。方法对6769例髋关节骨性关节炎患者采用直接前路进行初步THA。其中，我们回顾性研究了需要手术干预的术后PPFF的发生情况。结果术后29髋（29/6769；0.43%）出现PPFF，从原发性THA到骨折发生的平均时间为9.2±8.5天。在这些骨折中，有13处（13/2170；0.60%）骨折发生在具有扁平锥形楔形柄的假体中，7处（7/1652；0.42%）骨折发生于直锥形柄，4处（4/1082；0.37%）骨折出现于水泥柄，1处（1/1.060；0.09%）骨折发生于带领完全羟基磷灰石涂层的假体中。完全羟基磷灰石涂层带领茎的PPFF发生率明显低于楔形扁平茎。5个髋关节（5/29；17.2%）需要再次手术干预。结论我们的研究结果表明，与扁平锥形楔形干管相比，使用带领全羟基磷灰石涂层的干管可降低直接前路THA术后早期PPFF的风险。

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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Journal of Joint Surgery and Research

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