Long-term results of the augmented PFNA: a prospective multicenter trial

Abstract

MethodsIn 5 european clinics, 62 patients (79 % female, mean age 85.3 years) suffering from an osteoporotic pertrochanteric fracture (AO 31) were treated with the augmented PFNA ® . The primary objectives were assessment of activities of daily living, pain and mobility. Furthermore, the X-rays were analyzed for the cortical thickness index, changes of the trabecular structure around the cement and the hip joint space. Results The mean follow-up time was 15.3 months. We observed callus healing in all cases. The surgical complication rate was 3.2 % with no complication related to the cement augmentation. A mean volume of 3.8 ml of cement was injected and no complication was reported due to this procedure. 59.9 % reached their prefracture mobility level until follow-up. The mean hip joint space did not change significantly until follow-up and there were no signs of osteonecrosis in the follow-up X-rays. Furthermore, no blade migration was assessed. Conclusion This study makes us believe that the standardized augmentation of the PFNA with a perforated blade is a safe method to treat pertrochanteric femoral fractures. It leads to good functional results and is not associated with cartilage or bone necrosis.

Cement Augmentation in Sacroiliac Screw Fixation Offers Modest Biomechanical Advantages in a Cadaver Model

“…Therefore, we used a cyclic loading protocol, because this seems to best approximate the clinical loading scenario. Preliminary clinical studies showed a decrease in implant loosening rates with cement augmentation in the osteoporotic proximal femur [20] and spine [38]. Cement augmentation of sacroiliac screw fixation has been reported in small case reports and series [41,46], and few complications were reported.…”

Augmentationstechnik am proximalen Femur

“…In einer Multicenterstudie, in der 62 Patienten mit einer osteoporoseassoziierten pertrochantären Femurfraktur in 5 Zentren prospektiv erfasst und mit einem zementaugmentierten PFNA versorgt wurden, zeigten sich gute funktionelle Ergebnisse nach einer mittleren Nachuntersuchungszeit von 15,3 Monaten [18]. Dabei konnten keine zementassoziierten Komplikationen beobachtet werden, weshalb die Zementaugmentation des PFNA als sicheres Verfahren eingestuft wurde.…”

“…In klinisch-prospektiven Untersuchungen zeigte die Zementaugmentation des PFNA bei orthogeriatrischen Patienten mit pertrochantärer Femurfraktur gute funktionelle Ergebnisse ohne Hinweise auf zementassoziierte Komplikationen [18,20].…”

“…(Mod. nachKammerlander et al 2014 [18]) a WHO-Performance-Status: 0 volle uneingeschränkte Aktivität, 4 bettlägeriger, immobiler Patient. Der Parker-Mobilisations-Status erfasst 4 Mobilisationsstufen, dabei bedeuten maximal 9 Punkte eine unabhängige freie Mobilisation des Patienten.…”

Augmentationstechnik am proximalen Humerus

“…Auch der Einsatz am Patienten zeigt erste vielversprechende Ergebnisse und keine spezifisch erhöhten Komplikationen im Langzeitverlauf [11,12].…”