Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 3/2010

01.03.2010 | Case Report

Case Report: Cementless Stem Stabilization after Intraoperative Fracture: A Radiostereometric Analysis

verfasst von: David Campbell, BMBS, FRACS, PhD, Graham Mercer, BMBS, FRACS, Kjell G. Nilsson, MSc, BVSc, DVSc, Stuart A. Callary, BAppSc

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 3/2010

Einloggen, um Zugang zu erhalten

Abstract

We present the case of a patient with intraoperative femoral fracture during THA, which was repaired using cerclage fixation and insertion of an hydroxyapatite-coated cementless stem. The patient was evaluated postoperatively using radiostereometry during a 2-year course, and despite a large amount of subsidence and rotation, stabilization occurred and was maintained by 6 months. By evaluating the pattern of stem migration after intraoperative fracture, this case shows, even in the presence of instability, a successful clinical outcome can be achieved using an hydroxyapatite-coated cementless stem.
Literatur
1.
Zurück zum Zitat Berend KR, Lombardi AV Jr, Mallory TH, Chonko DJ, Dodds KL, Adams JB. Cerclage wires or cables for the management of intraoperative fracture associated with a cementless, tapered femoral prosthesis: results at 2 to 16 years. J Arthroplasty. 2004;19(7 suppl 2):17–21.CrossRefPubMed Berend KR, Lombardi AV Jr, Mallory TH, Chonko DJ, Dodds KL, Adams JB. Cerclage wires or cables for the management of intraoperative fracture associated with a cementless, tapered femoral prosthesis: results at 2 to 16 years. J Arthroplasty. 2004;19(7 suppl 2):17–21.CrossRefPubMed
3.
Zurück zum Zitat Berry DJ. Management of periprosthetic fractures: the hip. J Arthroplasty. 2002;17(4 suppl 1):11–13.CrossRefPubMed Berry DJ. Management of periprosthetic fractures: the hip. J Arthroplasty. 2002;17(4 suppl 1):11–13.CrossRefPubMed
4.
Zurück zum Zitat Borlin N, Rohrl SM, Bragdon CR. RSA wear measurements with or without markers in total hip arthroplasty. J Biomech. 2006;39:1641–1650.CrossRefPubMed Borlin N, Rohrl SM, Bragdon CR. RSA wear measurements with or without markers in total hip arthroplasty. J Biomech. 2006;39:1641–1650.CrossRefPubMed
5.
Zurück zum Zitat Bragdon CR, Thanner J, Greene ME, Malchau H, Digas G, Harris WH, Karrholm J. Standing versus supine radiographs in RSA evaluation of femoral head penetration. Clin Orthop Relat Res. 2006;448:46–51.CrossRefPubMed Bragdon CR, Thanner J, Greene ME, Malchau H, Digas G, Harris WH, Karrholm J. Standing versus supine radiographs in RSA evaluation of femoral head penetration. Clin Orthop Relat Res. 2006;448:46–51.CrossRefPubMed
6.
Zurück zum Zitat Froimson MI, Garino J, Machenaud A, Vidalain JP. Minimum 10-year results of a tapered, titanium, hydroxyapatite-coated hip stem: an independent review. J Arthroplasty. 2007;22:1–7.CrossRefPubMed Froimson MI, Garino J, Machenaud A, Vidalain JP. Minimum 10-year results of a tapered, titanium, hydroxyapatite-coated hip stem: an independent review. J Arthroplasty. 2007;22:1–7.CrossRefPubMed
7.
Zurück zum Zitat Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed
8.
Zurück zum Zitat Karrholm J, Borssen B, Lowenhielm G, Snorrason F. Does early micromotion of femoral stem prostheses matter? 4-7-year stereoradiographic follow-up of 84 cemented prostheses. J Bone Joint Surg Br. 1994;76:912–917.PubMed Karrholm J, Borssen B, Lowenhielm G, Snorrason F. Does early micromotion of femoral stem prostheses matter? 4-7-year stereoradiographic follow-up of 84 cemented prostheses. J Bone Joint Surg Br. 1994;76:912–917.PubMed
9.
Zurück zum Zitat Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J. Radiostereometry of hip prostheses: review of methodology and clinical results. Clin Orthop Relat Res. 1997;344:94–110.PubMed Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J. Radiostereometry of hip prostheses: review of methodology and clinical results. Clin Orthop Relat Res. 1997;344:94–110.PubMed
10.
Zurück zum Zitat Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C. The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-Analyse-femoral component analysis. J Bone Joint Surg Br. 1999;81:273–280.CrossRefPubMed Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C. The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-Analyse-femoral component analysis. J Bone Joint Surg Br. 1999;81:273–280.CrossRefPubMed
11.
Zurück zum Zitat Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury. 2007;38:651–654.CrossRefPubMed Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury. 2007;38:651–654.CrossRefPubMed
12.
Zurück zum Zitat Malchau H, Karrholm J, Wang YX, Herberts P. Accuracy of migration analysis in hip arthroplasty: digitized and conventional radiography, compared to radiostereometry in 51 patients. Acta Orthop Scand. 1995;66:418–424.PubMedCrossRef Malchau H, Karrholm J, Wang YX, Herberts P. Accuracy of migration analysis in hip arthroplasty: digitized and conventional radiography, compared to radiostereometry in 51 patients. Acta Orthop Scand. 1995;66:418–424.PubMedCrossRef
13.
Zurück zum Zitat Meek RM, Garbuz DS, Masri BA, Greidanus NV, Duncan CP. Intraoperative fracture of the femur in revision total hip arthroplasty with a diaphyseal fitting stem. J Bone Joint Surg Am. 2004;86:480–485.PubMed Meek RM, Garbuz DS, Masri BA, Greidanus NV, Duncan CP. Intraoperative fracture of the femur in revision total hip arthroplasty with a diaphyseal fitting stem. J Bone Joint Surg Am. 2004;86:480–485.PubMed
14.
Zurück zum Zitat Salemyr MF, Skoldenberg OG, Boden HG, Ahl TE, Adolphson PY. Good results with an uncemented proximally HA-coated stem in hip revision surgery: 62 hips followed for 2–13 years. Acta Orthop. 2008;79:184–193.CrossRefPubMed Salemyr MF, Skoldenberg OG, Boden HG, Ahl TE, Adolphson PY. Good results with an uncemented proximally HA-coated stem in hip revision surgery: 62 hips followed for 2–13 years. Acta Orthop. 2008;79:184–193.CrossRefPubMed
15.
Zurück zum Zitat Schutzer SF, Grady-Benson J, Jasty M, O’Connor DO, Bragdon C, Harris WH. Influence of intraoperative femoral fractures and cerclage wiring on bone ingrowth into canine porous-coated femoral components. J Arthroplasty. 1995;10:823–829.CrossRefPubMed Schutzer SF, Grady-Benson J, Jasty M, O’Connor DO, Bragdon C, Harris WH. Influence of intraoperative femoral fractures and cerclage wiring on bone ingrowth into canine porous-coated femoral components. J Arthroplasty. 1995;10:823–829.CrossRefPubMed
16.
Zurück zum Zitat Schwartz JT Jr, Mayer JG, Engh CA. Femoral fracture during non-cemented total hip arthroplasty. J Bone Joint Surg Am. 1989;71:1135–1142.PubMed Schwartz JT Jr, Mayer JG, Engh CA. Femoral fracture during non-cemented total hip arthroplasty. J Bone Joint Surg Am. 1989;71:1135–1142.PubMed
17.
Zurück zum Zitat Sharkey PF, Hozack WJ, Booth RE Jr, Rothman RH. Intraoperative femoral fractures in cementless total hip arthroplasty. Orthop Rev. 1992;21:337–342.PubMed Sharkey PF, Hozack WJ, Booth RE Jr, Rothman RH. Intraoperative femoral fractures in cementless total hip arthroplasty. Orthop Rev. 1992;21:337–342.PubMed
18.
Zurück zum Zitat Strom H, Mallmin H, Milbrink J, Petren-Mallmin M, Nivbrant B, Kolstad K. The cone hip stem: a prospective study of 13 patients followed for 5 years with RSA. Acta Orthop Scand. 2003;74:525–530.PubMedCrossRef Strom H, Mallmin H, Milbrink J, Petren-Mallmin M, Nivbrant B, Kolstad K. The cone hip stem: a prospective study of 13 patients followed for 5 years with RSA. Acta Orthop Scand. 2003;74:525–530.PubMedCrossRef
19.
Zurück zum Zitat Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. Early migration pattern of the uncemented CLS stem in total hip arthroplasties. Clin Orthop Relat Res. 2007;454:127–132.CrossRefPubMed Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. Early migration pattern of the uncemented CLS stem in total hip arthroplasties. Clin Orthop Relat Res. 2007;454:127–132.CrossRefPubMed
20.
Zurück zum Zitat Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. J Arthroplasty. 2007;22:1122–1129.CrossRefPubMed Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. J Arthroplasty. 2007;22:1122–1129.CrossRefPubMed
21.
Zurück zum Zitat Stuchin SA. Femoral shaft fracture in porous and press-fit total hip arthroplasty. Orthop Rev. 1990;19:153–159.PubMed Stuchin SA. Femoral shaft fracture in porous and press-fit total hip arthroplasty. Orthop Rev. 1990;19:153–159.PubMed
22.
Zurück zum Zitat von Schewelov T, Onsten I, Markusson P, Carlsson A. Weight bearing radiographs are not necessary for measurement of polyethylene penetration in total hip prostheses: a radiostereometric study of 111 patients examined in weight-bearing and supine position. Acta Orthop. 2006;77:104–108.CrossRef von Schewelov T, Onsten I, Markusson P, Carlsson A. Weight bearing radiographs are not necessary for measurement of polyethylene penetration in total hip prostheses: a radiostereometric study of 111 patients examined in weight-bearing and supine position. Acta Orthop. 2006;77:104–108.CrossRef
Metadaten
Titel
Case Report: Cementless Stem Stabilization after Intraoperative Fracture: A Radiostereometric Analysis
verfasst von
David Campbell, BMBS, FRACS, PhD
Graham Mercer, BMBS, FRACS
Kjell G. Nilsson, MSc, BVSc, DVSc
Stuart A. Callary, BAppSc
Publikationsdatum
01.03.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 3/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1082-5

Weitere Artikel der Ausgabe 3/2010

Clinical Orthopaedics and Related Research® 3/2010 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.