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Early Post-operative Periprosthetic Femur Fracture in the Presence of a Non-cemented Tapered Wedge Femoral Stem

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HSS Journal

Abstract

Non-cemented femoral fixation in hip arthroplasty has become the standard of practice in the USA. However, recent literature has brought attention to an increasing incidence of periprosthetic femur fractures with certain stem designs. This study examines reasons for early periprosthetic femur fractures in patients with a hip arthroplasty performed using a non-cemented tapered wedge stem design. A multivariate analysis using a matched-cohort design was performed to assess any potential risk factors that may predispose to such fractures. Six of 2,220 hips (0.3%) suffered a periprosthetic femur fracture within the first year after surgery; five of six were Vancouver Type B2. The average time to fracture was 9 weeks. This group of patients had a significantly higher canal–flare index and lower canal–calcar ratio. This complication may be preventable by having a better appreciation of the fit between the implant and the bone during pre-operative planning, with the goal of avoiding a proximal–distal mismatch.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Lenox Hill Hospital, William Black Hall, 11th Floor, 130 East 77th Street, New York, NY, 10075, USA

    H. John Cooper MD & José A. Rodriguez MD

Authors
  1. H. John Cooper MD
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  2. José A. Rodriguez MD
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Correspondence to H. John Cooper MD.

Additional information

No financial support was received in this study. Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Prior to the commencement of this study, approval for this study was obtained from the Institutional Review Board of our institution. Research was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. Each author certifies that his or her institution has approved the reporting of these cases and that all investigations were conducted in conformity with ethical principles of research.

Level of evidence: Level III: Prognostic Study.

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Cooper, H.J., Rodriguez, J.A. Early Post-operative Periprosthetic Femur Fracture in the Presence of a Non-cemented Tapered Wedge Femoral Stem. HSS Jrnl 6, 150–154 (2010). https://doi.org/10.1007/s11420-010-9161-4

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  • DOI: https://doi.org/10.1007/s11420-010-9161-4

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