Revisionsendoprothetik der Hüfte

Rath, Björn; Eschweiler, Jörg; Beckmann, Johannes; Migliorini, Filippo; Alrawashdeh, Waleed; Tingart, Markus

doi:10.1007/s00132-019-03704-x

Cited by 2 publications

(1 citation statement)

References 44 publications

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“…Our results of smaller cup sizes tending to be associated with less dislocation rates after BHA are contradictory to the literature. To our knowledge, the small sample size is the most likely reason for this discrepancy [21].…”

Section: Discussionmentioning

confidence: 90%

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Graulich

Graeff

Jaiman

et al. 2020

Eur J Orthop Surg Traumatol

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Purpose Bipolar hemiarthroplasty has been shown to have a lower rate of dislocation than total hip arthroplasty. However, as the influencing risk factors for bipolar hemiarthroplasty dislocation remain unclear, we aimed to analyse patient and surgeon-specific influencing risk factors for bipolar hemiarthroplasty dislocation. Methods We retrospectively analysed patients who were operated between 2012 and 2018 and had dislocated bipolar hemiarthroplasty and matched them to patients without a dislocated bipolar hemiarthroplasty, operated between 2018 and 2019. The study was limited to patients who received either a pre- or postoperative pelvic computed tomography. Besides demographic, morphologic, and physiologic data, we analysed duration of surgery; ASA score; Charlson Comorbidity Index; Almelo Hip Fracture Score; Parker Score; and acetabular morphology angles including acetabular anteversion angle, posterior acetabular sector angle, posterior wall angle, and acetabular roofing. Results We included nine patients with a dislocated bipolar hemiarthroplasty and 30 with a non-dislocated bipolar hemiarthroplasty. Patient-specific factors prompting a higher risk for dislocated bipolar hemiarthroplasty were longer duration of surgery (min) (115 ± 50 vs. 80 ± 27, p = 0.01); dementia (56% vs. 13%, p < 0.01); smaller posterior acetabular sector angle (°) (96 ± 6 vs. 109 ± 10, p < 0.01); and smaller posterior wall angle (°) (67 ± 6 vs. 77 ± 10, p = 0.02). Conclusion Dementia and insufficient posterior wall angle were associated with higher risk of dislocation in bipolar hemiarthroplasty

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Section: Discussionmentioning

confidence: 90%

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Graulich

Graeff

Jaiman

et al. 2020

Eur J Orthop Surg Traumatol

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Mechanical failure of 113 uncemented modular revision femoral components

Krueger

Guenther

Deml

et al. 2020

The Bone & Joint Journal

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Aims We evaluated a large database with mechanical failure of a single uncemented modular femoral component, used in revision hip arthroplasty, as the end point and compared them to a control group treated with the same implant. Patient- and implant-specific risk factors for implant failure were analyzed. Methods All cases of a fractured uncemented modular revision femoral component from one manufacturer until April 2017 were identified and the total number of implants sold until April 2017 was used to calculate the fracture rate. The manufacturer provided data on patient demographics, time to failure, and implant details for all notified fractured devices. Patient- and implant-specific risk factors were evaluated using a logistic regression model with multiple imputations and compared to data from a previously published reference group, where no fractures had been observed. The results of a retrieval analysis of the fractured implants, performed by the manufacturer, were available for evaluation. Results There were 113 recorded cases with fracture at the modular junction, resulting in a calculated fracture rate of 0.30% (113/37,600). The fracture rate of the implant without signs of improper use was 0.11% (41/37,600). In 79% (89/113) of cases with a failed implant, either a lateralized (high offset) neck segment, an extralong head, or the combination of both were used. Logistic regression analysis revealed male sex, high body mass index (BMI), straight component design, and small neck segments were significant risk factors for failure. Investigation of the implants (76/113) showed at least one sign of improper use in 72 cases. Conclusion Implant failure at the modular junction is associated with patient- and implant-specific risk factors as well as technical errors during implantation. Whenever possible, the use of short and lateralized neck segments should be avoided with this revision system. Implantation instructions and contraindications need to be adhered to and respected. Cite this article: Bone Joint J 2020;102-B(5):573–579.

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Revisionsendoprothetik der Hüfte

Cited by 2 publications

References 44 publications

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Mechanical failure of 113 uncemented modular revision femoral components

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