Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Lee, Soong Joon; Yoon, Kang Sup

doi:10.5371/hp.2019.31.1.11

Cited by 5 publications

(4 citation statements)

References 23 publications

(48 reference statements)

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“…In this study, we observed radiolucent lines in 55.8% of all hips 1 year after surgery, half of which (50%) occurred in zone 1. A previous study using the Tri-Lock BPS noted the occurrence of radiolucent lines in zone 1 in 42.1% of the operated hips at 2.9 years after surgery, 25 which is similar to our results. We also found a marked decrease in the frequency of radiolucent lines in 9.5% of patients, 5 years postoperatively.…”

Section: Discussionsupporting

confidence: 92%

Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty

Masuda

Iwakiri²,

Ohta

et al. 2023

HIP International

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Aim: This study aimed to assess the relationship between the three-dimensional (3D) alignment of short tapered-wedge cementless stems and bone mineral density (BMD) changes in patients followed up for 5 years after total hip arthroplasty (THA). Methods: We retrospectively analysed the hips of 52 patients who underwent THA using short tapered-wedge cementless stems at our institution from 2013 to 2016 with complete 5-year follow-up data. We evaluated the relationship between stem alignment, measured using a 3D-templating software, and BMD changes in the 7 Gruen zones. Results: After 1 year, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD in zones 3 and 4 were noted. After 5 years, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD zones 2, 3, and 4 were observed. With increased amounts of varus/flexion stem alignment, the amount of BMD loss decreased. There was no correlation between anteverted stem insertion and changes in BMD levels. Conclusions: Our data showed that stem alignment affects BMD based on 5-year follow-up data after surgery. Careful observation is necessary, especially when using short tapered-wedge cementless stems, as stem alignment may affect changes in BMD levels more than 5 years after surgery.

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Section: Discussionsupporting

confidence: 92%

Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty

Masuda

Iwakiri²,

Ohta

et al. 2023

HIP International

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“…Among arthroplasties for the treatment of intracapsular femoral neck fractures also the usage of short stem prothesis showed good results [ 24 ]. Even in patients with osteoporotic fractures sufficient results with stable bony integration was found [ 25 ]. Among the osteosynthesis the dynamic compression screw was mostly used, but number of procures decreases with increasing patient age.…”

Section: Discussionmentioning

confidence: 99%

Incidence and treatment of intracapsular femoral neck fractures in Germany

Szymski

Walter

Lang

et al. 2022

Arch Orthop Trauma Surg

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Introduction Intracapsular femoral neck fractures are one of the most common fractures in Germany. Nevertheless, the epidemiology and treatment modalities are not described comprehensively. For this reason, this study highlights the epidemiology of femoral neck fractures in different age groups and summarizes treatment strategies within the period from 2009 to 2019 based on nationwide data. Materials and methods In this retrospective cohort study all cases of intracapsular femoral neck fractures (ICD-10: S72.0) between 2009 and 2019 in Germany were analyzed with regard to epidemiology, incidence and treatment. Operation and procedure classification system (OPS)- codes in combination with intracapsular femoral neck fracture as main diagnosis were taken to investigation. Data was provided by the Federal Statistical Office of Germany (Destatis). Results A total of 807,834 intracapsular femoral neck fractures with a mean incidence of 110.0 per 100,000 inhabitants annually was detected within eleven years. In 68.8% of all fractures patients were female. Most patients were older than 70 years (82.4%), and 56.7% were older than 80 years. The overall increase of fracture numbers between 2009 and 2019 was 23.2%. Joint replacement has been most often performed (80.4%). Hemiarthroplasty (56.8%) and total hip arthroplasty (22.8%) were the most common procedures with an increase of 27.1 and 38.6%, respectively. The proportion of cemented hemiarthroplasties was 86.2% while 51.3% of all total hip arthroplasties were totally or partially cemented. Osteosyntheses were mainly conducted using dynamic compression screws (34.0%), conventional screws (31.3%) and nails (22.2%). Conclusion The incidence of intracapsular femoral neck fractures in Germany has been increasing continuously within the last decade. In particular, patients over 80 years suffered predominantly from this type of fracture. The majority was treated with a joint replacement procedure, mainly cemented hemiarthroplasty.

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“…Statistical analysis of the results of patients under 70 years and older than 70 years has not shown significant differences (p > 0.05) and it is shown that there is no contraindication in the use of short stems only due to age. 25–27…”

Section: Discussionmentioning

confidence: 99%

Medium-term outcomes of short stems in total hip arthroplasty

Cano¹,

Molina²,

Puertolas³

2022

Journal of Orthopaedics, Trauma and Rehabilitation

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Background Prosthetic surgery has shown good short-term results with the use of short stems, results comparable with the experience of conventional stems. The aim of this study was to investigate and describe the characteristics and clinical course of patients operated on with the short stem GTS in the medium term. Methods Between November 2010 and September 2014, 152 primary hip prostheses were operated on in 142 patients with a mean follow-up of 95.49 months (range 75–120). We analyzed the intraoperative and postoperative complications and the reviews performed during the follow-up. Results One intraoperative complications occurred; case in which a femoral calcar fracture occurred and a screw was required during the operation. The clinical evaluation at the end of the follow-up, according to the Merle D’Aubigne Scale, showed the mean value was 17.3684 (SD 0,79472), with a survival at the end of the follow-up of 99.3% of the placed GTS stems. Conclusions GTS short stems have shown good results after more than 6 years of follow-up, with comparable results to conventional uncemented stems. Short-stem hip arthroplasty is an advanced way to preserve bone stock while protecting soft tissue

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Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Cited by 5 publications

References 23 publications

Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty

Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty

Incidence and treatment of intracapsular femoral neck fractures in Germany

Medium-term outcomes of short stems in total hip arthroplasty

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