title: Intraoperative Periprosthetic Femur Fracture: A Biomechanical Analysis of Cerclage Fixation.
abstract: Intraoperative periprosthetic femur fracture is a known complication of total hip arthroplasty (THA) and a variety of cerclage systems are available to manage these fractures. The purpose of this study was to examine the in situ biomechanical response of cerclage systems for fixation of periprosthetic femur fractures that occur during cementless THA. We compared cobalt chrome (CoCr) cables, synthetic cables, monofilament wires and hose clamps under axial compressive and torsional loading. Metallic constructs with a positive locking system performed the best, supporting the highest loads with minimal implant subsidence (both axial and angular) after loading. Overall, the CoCr cable and hose clamp had the highest construct stiffness and least reduction in stiffness with increased loading. They were not demonstrably different from each other.
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Frisch
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Charters
authors.affiliation: Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Jakub
authors.initials: J
authors.lastname: Sikora-Klak
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Banglmaier
authors.affiliation: Bone and Joint Center, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Oravec
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Silverton
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D001864:Bone Wires; D005264:Femoral Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000293:injuries / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D007431:Intraoperative Complications; D008953:Models, Anatomic; D057068:Periprosthetic Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
keywords: cerclage; complication; fixation; periprosthetic fracture; revision; total hip arthroplasty