Abstract
The incidence of intraoperative femoral fractures with a single design of stem implant, the Meridian (Stryker-Howmedica, Rutherford, N.J.), has been assessed in a study of 117 implants in patients treated consecutively between 1996 and 2001. The aim of the study was to evaluate the risk factors for suffering an intraoperative fracture and to determine, based on a short-term follow-up, if there were radiographic signs of early loosening. The following variables were analysed: demographic factors of the patient, morphology of the femur, intraoperative factors and postoperative radiographic factors. The radiographic stability of the implant and the presence of early signs of loosening were evaluated 2 years after surgery. The incidence of femoral fractures was 11% (13 cases in 117 implants), which is higher that reported in earlier published studies, and there was an increased number of fractures when the proximal filling of the femoral canal was higher. Although there was no statistically significant relation between the variables studied and the appearance of an intraoperative fracture, we conclude that the appearance of a femoral intraoperative fracture did not affect the radiographic stability of the implant during the short-term follow-up of our study cohort.
Résumé
L’incidence des fractures peropératoires a été évaluée chez des patients traités par l’implant Méridian (Stryker - Howmedica, Rutherford, NJ). Nous avons étudié une série consécutive de 117 implants réalisée entre 1996 et 2001. Nous avons également essayé de déterminer quels étaient les facteurs de risque de fractures peropératoires et essayé de visualiser les signes précoces de descellement sur un suivi relativement court. Les éléments suivants ont été pris en compte : facteur démographique du patient, morphologie du fémur, facteur peropératoire et radiographies post opératoires. La stabilité radiographique de l’implant et la présence de signes précoces de descellement ont été évalués deux ans après l’intervention. L’incidence des fractures peropératoires du fémur a été de 11% (13 cas sur 117), plus importantes que dans d’autres séries publiées. Le taux de fracture a été plus important lorsque les contacts entre la pièce fémorale et le canal fémoral ont été très élevés. Il n’y a pas de relation significative entre les facteurs étudiés et l’apparition, entre ces différents facteurs, d’une fracture peropératoire. Quoiqu’il en soit, l’existence d’une fracture peropératoire n’entraîne pas d’instabilité radiographique de l’implant au suivi à court terme.
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An erratum to this article is available at http://dx.doi.org/10.1007/s00264-007-0339-4.
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Fernandez-Fernandez, R., García-Elias, E. & Gil-Garay, E. Peroperative fractures in uncemented total hip arthrography: results with a single design of stem implant. International Orthopaedics (SICO 32, 307–313 (2008). https://doi.org/10.1007/s00264-006-0318-1
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DOI: https://doi.org/10.1007/s00264-006-0318-1