title: Intraoperative Proximal Femoral Fracture in Primary Cementless Total Hip Arthroplasty.
abstract: Intraoperative proximal femoral fracture is a complication of primary cementless total hip arthroplasty (THA) at rates of 2.95-27.8%. A retrospective review of 2423 consecutive primary cementless THA cases identified 102 hips (96 patients) with fracture. Multivariate analysis compared fracture incidences between implants, Accolade (Stryker Orthopaedics) and Tri-Lock (DePuy Orthopaedics, Inc.), and evaluated potential risk factors using a randomized control group of 1150 cases without fracture. The fracture incidence was 4.4% (102/2423), 3.7% (36/1019) using Accolade and 4.9% using Tri-Lock (66/1404) (P=0.18). Female gender (OR=1.96; 95% CI 1.19-3.23; P=0.008) and smaller stem size (OR=1.64; 95% CI 1.04-2.63; P=0.03) predicted increased odds of fracture. No revisions of the femoral component were required in the fracture cohort.
authors: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors: Danielle Y
authors: DY
authors: Ponzio
authors: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors: Alisina
authors: A
authors: Shahi
authors: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors: Andrew G
authors: AG
authors: Park
authors: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors: James J
authors: JJ
authors: Purtill
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002484:Cementation; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000209:etiology; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors
keywords: calcar fracture; cementless hip arthroplasty; cerclage; femoral fracture; press-fit; total hip arthroplasty