Location
Suwanee, GA
Start Date
7-5-2024 1:00 PM
End Date
7-5-2024 4:00 PM
Description
Background: The use of cemented femoral fixation during hip arthroplasty for femoral neck fracture (FNF) is often recommended due to a widely reported decreased risk of early perioperative fracture and reoperation. However, newer generation cementless, collared, triple-tapered stems, may offer advantages over more traditional press fit femoral components. The purpose of this study was to investigate the 30-day survivorship of a modern, collared cementless stem when treating FNFs with hip arthroplasty through the direct anterior (DA) approach.
Methods: We conducted a retrospective study of all patients who underwent hemiarthroplasty (HA) and total hip arthroplasty (THA) for isolated displaced FNF between 2019 and 2023. All procedures were performed through the DA approach using a collared modern triple-tapered femoral stem. The primary outcome was 30-day stem survival. Secondary outcomes included all-cause reoperation and medical and surgical complications.
Results: The analysis included 202 patients, with a mean age of 76.4 (range: 43-100) and 70.8% women. Total hip arthroplasty was performed in 74.3%, while 25.7% underwent hemiarthroplasty. At 30 days, no stems required revision. The overall reoperation rate was 5.4% (9/166), including three infections, two dislocations, one adverse suture reaction, and three postoperative periprosthetic fractures. There was one intraoperative greater trochanter fracture resulting from errant retractor placement, which was stable and treated without fixation.
Conclusion: Our results suggest that a collared modern cementless triple-tapered stem may offer a safe and efficient alternative to cemented femoral fixation following FNF. The low rate of intraoperative and postoperative periprosthetic fractures seen in this series was comparable to previous published data on cemented fixation. Further medium to long-term studies are needed to determine the longevity of these implants within this patient population.
Embargo Period
6-24-2024
Included in
A Modern Collared Cementless Femoral Stem for the Arthroplasty Treatment of Femoral Neck Fractures
Suwanee, GA
Background: The use of cemented femoral fixation during hip arthroplasty for femoral neck fracture (FNF) is often recommended due to a widely reported decreased risk of early perioperative fracture and reoperation. However, newer generation cementless, collared, triple-tapered stems, may offer advantages over more traditional press fit femoral components. The purpose of this study was to investigate the 30-day survivorship of a modern, collared cementless stem when treating FNFs with hip arthroplasty through the direct anterior (DA) approach.
Methods: We conducted a retrospective study of all patients who underwent hemiarthroplasty (HA) and total hip arthroplasty (THA) for isolated displaced FNF between 2019 and 2023. All procedures were performed through the DA approach using a collared modern triple-tapered femoral stem. The primary outcome was 30-day stem survival. Secondary outcomes included all-cause reoperation and medical and surgical complications.
Results: The analysis included 202 patients, with a mean age of 76.4 (range: 43-100) and 70.8% women. Total hip arthroplasty was performed in 74.3%, while 25.7% underwent hemiarthroplasty. At 30 days, no stems required revision. The overall reoperation rate was 5.4% (9/166), including three infections, two dislocations, one adverse suture reaction, and three postoperative periprosthetic fractures. There was one intraoperative greater trochanter fracture resulting from errant retractor placement, which was stable and treated without fixation.
Conclusion: Our results suggest that a collared modern cementless triple-tapered stem may offer a safe and efficient alternative to cemented femoral fixation following FNF. The low rate of intraoperative and postoperative periprosthetic fractures seen in this series was comparable to previous published data on cemented fixation. Further medium to long-term studies are needed to determine the longevity of these implants within this patient population.
Comments
Presented by Ryan DeCook.