title: Long-term outcome and risk factors of proximal femoral fracture in uncemented and cemented total hip arthroplasty in 2551 hips.
abstract: Proximal femoral fractures are relatively common during total hip arthroplasty. The purposes of this study were to identify risk factors associated with femoral fractures and determine their effect on femoral stem survivorship. A total of 2551 hips were examined with up to 16 years of follow-up (mean, 6.8 years). Seventy-five percent of the stems were cemented. The incidence of proximal femoral fracture was 2.3% (59 hips). Risk factors associated with fractures include anterolateral approach, uncemented femoral fixation, and female sex (P < .01). Cerclage wiring was the most common treatment. After a fracture, femoral component survivorship was 95.8% for uncemented stems and 91.7% for cemented stems. In the absence of fracture, stem survivorship was 98.6% for cemented stems and 100% for circumferentially coated tapered titanium uncemented stems.
authors.affiliation: Center for Hip and Knee Surgery, St. Francis Hospital-Mooresville, Mooresville, Indiana, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Berend
authors.forename: Asher
authors.initials: A
authors.lastname: Smith
authors.forename: John B
authors.initials: JB
authors.lastname: Meding
authors.forename: Merrill A
authors.initials: MA
authors.lastname: Ritter
authors.forename: Timothy
authors.initials: T
authors.lastname: Lynch
authors.forename: Kenneth
authors.initials: K
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001672:Biocompatible Materials / Q000009:adverse effects*; D001843:Bone Cements; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012307:Risk Factors; D014025:Titanium / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D001843:Bone Cements; D014025:Titanium