Cementless total hip arthroplasty for patients previously treated with femoral osteotomy for hip dysplasia: the incidence of periprosthetic fracture

Masanobu Ohishi, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Jun ichi Fukushi, Satoshi Hamai, Yusuke Kohno, Yukihide Iwamoto

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Femur deformities can make stem fixation difficult in total hip arthroplasty (THA). We report the clinical results of cementless THA using a press-fit stem in patients who had previously undergone femoral osteotomy for hip dysplasia. Methods: The subjects included 66 hips in 64 patients, with the mean follow-up period of 7.3 years. THA was performed at a mean period of 17.1 years after intertrochanteric femoral osteotomy. Valgus osteotomy was performed in 42 hips, and varus osteotomy in 24. Clinical results were evaluated by using the Merle d’Aubigne-Postel score. Implant survival was determined with revision as the end point, and any related complications were investigated. Results: The Merle d’Aubigne-Postel score improved from 9.4 to 16.1 at the final follow-up, without any implant loosening. However, periprosthetic femoral fractures were observed in four hips (6.0 %), one intra-operatively and three within three weeks after THA. Among these cases, three hips previously had varus osteotomy (12.5 %) and one hip had valgus osteotomy (2.3 %). Two hips were revised with full porous stems and circumferential wiring. The five and ten year cumulative survivorship rates were 97 % (range, 88.8–99.3 %) and 97 % (88.8–99.3 %), respectively. Conclusions: Although the use of a press-fit cementless stem yielded acceptable results in most of the patients, perioperative femoral fracture was a major complication especially in the patients previously treated with intertrochanteric varus osteotomy. Careful planning and implant selection could be emphasized for these cases.

Original languageEnglish
Pages (from-to)1601-1606
Number of pages6
JournalInternational Orthopaedics
Volume40
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

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Periprosthetic Fractures
Hip Dislocation
Osteotomy
Thigh
Arthroplasty
Hip
Incidence
Femoral Fractures
Femur
Survival Rate

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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Cementless total hip arthroplasty for patients previously treated with femoral osteotomy for hip dysplasia : the incidence of periprosthetic fracture. / Ohishi, Masanobu; Nakashima, Yasuharu; Yamamoto, Takuaki; Motomura, Goro; Fukushi, Jun ichi; Hamai, Satoshi; Kohno, Yusuke; Iwamoto, Yukihide.

In: International Orthopaedics, Vol. 40, No. 8, 01.08.2016, p. 1601-1606.

Research output: Contribution to journalArticle

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abstract = "Purpose: Femur deformities can make stem fixation difficult in total hip arthroplasty (THA). We report the clinical results of cementless THA using a press-fit stem in patients who had previously undergone femoral osteotomy for hip dysplasia. Methods: The subjects included 66 hips in 64 patients, with the mean follow-up period of 7.3 years. THA was performed at a mean period of 17.1 years after intertrochanteric femoral osteotomy. Valgus osteotomy was performed in 42 hips, and varus osteotomy in 24. Clinical results were evaluated by using the Merle d’Aubigne-Postel score. Implant survival was determined with revision as the end point, and any related complications were investigated. Results: The Merle d’Aubigne-Postel score improved from 9.4 to 16.1 at the final follow-up, without any implant loosening. However, periprosthetic femoral fractures were observed in four hips (6.0 {\%}), one intra-operatively and three within three weeks after THA. Among these cases, three hips previously had varus osteotomy (12.5 {\%}) and one hip had valgus osteotomy (2.3 {\%}). Two hips were revised with full porous stems and circumferential wiring. The five and ten year cumulative survivorship rates were 97 {\%} (range, 88.8–99.3 {\%}) and 97 {\%} (88.8–99.3 {\%}), respectively. Conclusions: Although the use of a press-fit cementless stem yielded acceptable results in most of the patients, perioperative femoral fracture was a major complication especially in the patients previously treated with intertrochanteric varus osteotomy. Careful planning and implant selection could be emphasized for these cases.",
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T1 - Cementless total hip arthroplasty for patients previously treated with femoral osteotomy for hip dysplasia

T2 - the incidence of periprosthetic fracture

AU - Ohishi, Masanobu

AU - Nakashima, Yasuharu

AU - Yamamoto, Takuaki

AU - Motomura, Goro

AU - Fukushi, Jun ichi

AU - Hamai, Satoshi

AU - Kohno, Yusuke

AU - Iwamoto, Yukihide

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N2 - Purpose: Femur deformities can make stem fixation difficult in total hip arthroplasty (THA). We report the clinical results of cementless THA using a press-fit stem in patients who had previously undergone femoral osteotomy for hip dysplasia. Methods: The subjects included 66 hips in 64 patients, with the mean follow-up period of 7.3 years. THA was performed at a mean period of 17.1 years after intertrochanteric femoral osteotomy. Valgus osteotomy was performed in 42 hips, and varus osteotomy in 24. Clinical results were evaluated by using the Merle d’Aubigne-Postel score. Implant survival was determined with revision as the end point, and any related complications were investigated. Results: The Merle d’Aubigne-Postel score improved from 9.4 to 16.1 at the final follow-up, without any implant loosening. However, periprosthetic femoral fractures were observed in four hips (6.0 %), one intra-operatively and three within three weeks after THA. Among these cases, three hips previously had varus osteotomy (12.5 %) and one hip had valgus osteotomy (2.3 %). Two hips were revised with full porous stems and circumferential wiring. The five and ten year cumulative survivorship rates were 97 % (range, 88.8–99.3 %) and 97 % (88.8–99.3 %), respectively. Conclusions: Although the use of a press-fit cementless stem yielded acceptable results in most of the patients, perioperative femoral fracture was a major complication especially in the patients previously treated with intertrochanteric varus osteotomy. Careful planning and implant selection could be emphasized for these cases.

AB - Purpose: Femur deformities can make stem fixation difficult in total hip arthroplasty (THA). We report the clinical results of cementless THA using a press-fit stem in patients who had previously undergone femoral osteotomy for hip dysplasia. Methods: The subjects included 66 hips in 64 patients, with the mean follow-up period of 7.3 years. THA was performed at a mean period of 17.1 years after intertrochanteric femoral osteotomy. Valgus osteotomy was performed in 42 hips, and varus osteotomy in 24. Clinical results were evaluated by using the Merle d’Aubigne-Postel score. Implant survival was determined with revision as the end point, and any related complications were investigated. Results: The Merle d’Aubigne-Postel score improved from 9.4 to 16.1 at the final follow-up, without any implant loosening. However, periprosthetic femoral fractures were observed in four hips (6.0 %), one intra-operatively and three within three weeks after THA. Among these cases, three hips previously had varus osteotomy (12.5 %) and one hip had valgus osteotomy (2.3 %). Two hips were revised with full porous stems and circumferential wiring. The five and ten year cumulative survivorship rates were 97 % (range, 88.8–99.3 %) and 97 % (88.8–99.3 %), respectively. Conclusions: Although the use of a press-fit cementless stem yielded acceptable results in most of the patients, perioperative femoral fracture was a major complication especially in the patients previously treated with intertrochanteric varus osteotomy. Careful planning and implant selection could be emphasized for these cases.

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