Intraoperative Proximal Femoral Fracture in Primary Cementless Total Hip Arthroplasty

Danielle Y Ponzio; Alisina Shahi; Andrew G Park; James J Purtill

doi:10.1016/j.arth.2015.02.043

Intraoperative Proximal Femoral Fracture in Primary Cementless Total Hip Arthroplasty

J Arthroplasty. 2015 Aug;30(8):1418-22. doi: 10.1016/j.arth.2015.02.043. Epub 2015 Mar 7.

Authors

Danielle Y Ponzio¹, Alisina Shahi¹, Andrew G Park¹, James J Purtill¹

Affiliation

¹ Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

PMID: 25791673
DOI: 10.1016/j.arth.2015.02.043

Abstract

Intraoperative proximal femoral fracture is a complication of primary cementless total hip arthroplasty (THA) at rates of 2.95-27.8%. A retrospective review of 2423 consecutive primary cementless THA cases identified 102 hips (96 patients) with fracture. Multivariate analysis compared fracture incidences between implants, Accolade (Stryker Orthopaedics) and Tri-Lock (DePuy Orthopaedics, Inc.), and evaluated potential risk factors using a randomized control group of 1150 cases without fracture. The fracture incidence was 4.4% (102/2423), 3.7% (36/1019) using Accolade and 4.9% using Tri-Lock (66/1404) (P=0.18). Female gender (OR=1.96; 95% CI 1.19-3.23; P=0.008) and smaller stem size (OR=1.64; 95% CI 1.04-2.63; P=0.03) predicted increased odds of fracture. No revisions of the femoral component were required in the fracture cohort.

Keywords: calcar fracture; cementless hip arthroplasty; cerclage; femoral fracture; press-fit; total hip arthroplasty.

MeSH terms

Aged
Arthroplasty, Replacement, Hip / adverse effects*
Arthroplasty, Replacement, Hip / methods
Cementation
Female
Femoral Fractures / etiology
Femoral Fractures / surgery*
Hip Joint / surgery*
Hip Prosthesis / adverse effects
Humans
Incidence
Intraoperative Complications / etiology
Joint Diseases / surgery*
Male
Middle Aged
Prosthesis Design
Retrospective Studies
Risk Factors