Intraoperative complications of revision hip arthroplasty using a fully porous-coated straight cobalt—chrome femoral stem

Intraoperative Periprosthetic Femur Fracture: A Biomechanical Analysis of Cerclage Fixation

“…The incidence of intraoperative periprosthetic femur fracture has been reported to be between 0.1-1% for cemented [1,2] and 5.4% for uncemented primary THA [2], compared to 3.6-12.5% in cemented [2,3] and 8.8-45.9% in uncemented revision THA [1,2,[4][5][6][7]. Risk factors for intraoperative periprosthetic femur fracture include the use of minimally invasive techniques [8], the use of press-fit cementless stems [1,2,[4][5][6]8,9], revision operations [1,2,[4][5][6]8,9], gender [8,9], bone loss or disease [3,5-8], and technical challenges at the time of the operation [8][9][10][11][12][13][14][15].Treatment options for periprosthetic femur fractures in uncemented THA depend on the site of the fracture and the stability of the implant as well as surgeon preference and comfort [16]. A number of options have been proposed ranging from combinations of long stem femoral components, extramedullary fixation with cerclage cables, plates, and strut grafts [6][7][8]15,17].…”

“…The incidence of intraoperative periprosthetic femur fracture has been reported to be between 0.1-1% for cemented [1,2] and 5.4% for uncemented primary THA [2], compared to 3.6-12.5% in cemented [2,3] and 8. .9% in uncemented revision THA [1,2,[4][5][6][7]. Risk factors for intraoperative periprosthetic femur fracture include the use of minimally invasive techniques [8], the use of press-fit cementless stems [1,2,[4][5][6]8,9], revision operations [1,2,[4][5][6]8,9], gender [8,9], bone loss or disease [3,[5][6][7][8], and technical challenges at the time of the operation [8][9][10][11][12][13][14][15].…”

Thermomechanical method for cement extraction in revision arthroplasty

“…The reported rate of intraoperative femoral fractures in cement extraction varies between 2 and 50% [5,6]. Biplanar setup fluoroscopically guided cement removal in revision total hip arthroplasty have lowered the risk of intraoperative bone injury [10].…”

“…They involve the use of chisels, cement drill bits, burs, highspeed drill bits, and windowing cortical bone, in order to remove the distal and/or proximal cement coat. Such procedures run a high risk of fracture, creating false passage and loss of substantial amounts of bone with subsequent impairment of its stability and longer operating times [5][6][7].…”

Bioball universal modular neck adapter as a salvage for failed revision total hip arthroplasty

“…Only long-term studies can show the effect of the titanium ions released into the surrounding tissues. These coated stems cannot be used in femora with Paprosky type IIIB defects with diameter >19 mm or in type IV defects,10 and intraoperative fractures are common with large diameter femoral stems 11…”