Low rate of early periprosthetic fractures in cementless short-stem total hip arthroplasty using a minimally invasive anterolateral approach

Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology

article

Luger, Matthias¹  Hipmair, Günter¹  Schopper, Clemens¹  Schauer, Bernhard¹  Hochgatterer, Rainer¹  Allerstorfer, Jakob¹  Gotterbarm, Tobias¹  Klasan, Antonio¹ 

[1] Department for Orthopedics and Traumatology, Kepler University Hospital GmbH;Johannes Kepler University Linz

关键词: Short stem;    Total hip arthroplasty;    Minimally invasive;    Anterolateral approach;    Watson-Jones;    Periprosthetic fracture;   

DOI  :  10.1186/s10195-021-00583-x

来源: Springer

【 摘 要 】

Minimally invasive (MIS) approaches in combination with short stems have gained popularity in recent years in total hip arthroplasty (THA). A decreased risk for periprosthetic femoral fractures (PFFs) is reported for cementless short-stem THA, but in contrast to other approaches, the risk factors for PFFs for short-stem THA using MIS anterolateral approach in supine position are not described in literature. A single-center consecutive series of 1052 hips in 982 patients, performed between 2014 and 2019 with a short curved stem and a press fit using an MIS anterolateral approach in supine position, was retrospectively screened for inclusion. Fourteen patients were lost to follow-up. Therefore, 1038 THAs in 968 patients were included. Risk factors for intra- and postoperative PFFs within 90 days were analyzed. We investigated for sex, age, body mass index (BMI), diagnosis, and laterality. In total, 18 PFFs (1.7%) occurred. Intraoperative fracture occurred in ten cases ( 0.9%), with another eight cases (0.8%) occurring postoperatively. Increased American Society of Anesthesiologists (ASA) Score was a significant risk factor for PFF (p = 0.026), whereas sex (p = 0.155), age (p = 0.161), BMI (p = 0.996), and laterality (p = 1.000) were not. Seven PFFs (0.7%) required revision arthroplasty. Cementless short-stem THA using the MIS anterolateral approach is a procedure with a low number of PFFs within 90 days from index surgery. Fracture rates are comparable to other MIS approaches, and comparable femoral short stems are used. Age, sex, and BMI were not identified as risk factors of PFF, while risk for PFF increased with ASA Score.

【 授权许可】

Unknown