title: Comparison of the outcome following the fixation of osteotomies or fractures associated with total hip replacement using cables or wires: the results at five years.
abstract: There are no recent studies comparing cable with wire for the fixation of osteotomies or fractures in total hip replacement (THR). Our objective was to evaluate the five-year clinical and radiological outcomes and complication rates of the two techniques. We undertook a review including all primary and revision THRs performed in one hospital between 1996 and 2005 using cable or wire fixation. Clinical and radiological evaluation was performed five years post-operatively. Cables were used in 51 THRs and wires in 126, and of these, 36 THRs with cable (71%) and 101 with wire (80%) were evaluated at follow-up. The five-year radiographs available for 33 cable and 91 wire THRs revealed rates of breakage of fixation of 12 of 33 (36%) and 42 of 91 (46%), respectively. With cable there was a significantly higher risk of metal debris (68% vs. 9%; adjusted relative risk (RR) 6.6; 95% confidence interval (CI) 3.0 to 14.1), nonunion (36% vs. 21%; adjusted RR 2.0; 95% CI 1.0 to 3.9) and osteolysis around the material, acetabulum or femur (61% vs 19%; adjusted RR 3.9; 95% CI 2.3 to 6.5). Cable breakage increased the risk of osteolysis to 83%. There was a trend towards foreign-body reaction and increased infection with cables. Clinical results did not differ between the groups. In conclusion, we found a higher incidence of complications and a trend towards increased infection and foreign-body reaction with the use of cables.
authors.affiliation: Geneva University Hospitals, Division of Orthopaedics and Trauma Surgery, 4 Rue Gabrielle-Perret-Gentil, CH-1211 Geneva, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Berton
authors.forename: G J
authors.initials: GJ
authors.lastname: Puskas
authors.forename: P
authors.initials: P
authors.lastname: Christofilopoulos
authors.forename: R
authors.initials: R
authors.lastname: Stern
authors.forename: P
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: A
authors.initials: A
authors.lastname: Lübbeke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001864:Bone Wires / Q000009:adverse effects*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices / Q000009:adverse effects*; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome