Increase of Cortical Bone After a Cementless Long Stem in Periprosthetic Fractures
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Clin Orthop Relat Res DOI 10.1007/s11999-013-2845-6
A Publication of The Association of Bone and Joint Surgeons®
SYMPOSIUM: 2012 INTERNATIONAL HIP SOCIETY PROCEEDINGS
Increase of Cortical Bone After a Cementless Long Stem in Periprosthetic Fractures Eduardo Garcı´a-Rey MD, PhD, EBOT, Eduardo Garcı´a-Cimbrelo MD, PhD, Ana Cruz-Pardos MD, PhD, Rosa´rio Madero MS
Ó The Association of Bone and Joint Surgeons1 2013
Abstract Background Healing and functional recovery have been reported using an extensively porous-coated stem in Vancouver B2 and B3 periprosthetic fractures; however, loss of cortical bone has been observed when using these stems in revision surgery for aseptic loosening. However, it is unclear whether this bone loss influences subsequent loosening. Question/purposes We analyze the healing fracture rate and whether the radiographic changes observed around and extensively porous-coated stem used for periprosthetic fractures affect function or loosening. Methods We retrospectively reviewed 35 patients with periprosthetic fractures (20 Vancouver B2 and 15
Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. E. Garcı´a-Rey (&), E. Garcı´a-Cimbrelo, A. Cruz-Pardos Orthopaedics Department, Hospital La Paz-IDi Paz, P8 Castellana 261, 28046 Madrid, Spain e-mail: [email protected] R. Madero Biostatistics Department, Hospital La Paz-IDi Paz, Madrid, Spain
Vancouver B3). Patients’ mean age at surgery was 80 years (range, 51–86 years). No cortical struts were used in this series. We evaluated radiographs for signs of loosening or subsidence. The cortical index and the femoral cortical width were measured at different levels on the immediate pre- and postoperative radiographs and at different periods of followup. The minimum followup was 3 years (mean, 8.3 years; range, 3–17 years). Results All fractures had healed, and all stems were clinically and radiographically stable at the end of followup. Nineteen hips showed nonprogressive radiographic subsidence during the first 3 postoperative months without clinical consequences. The cortical index and the lateral and medial cortical thickness
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