DOS 2016

DOS Kongressen 2016 ·

181

Intraoperative and early postoperative

periprosthetic femoral fractures after total hip

arthroplasty

Martin Lindberg-Larsen, Christoffer Jørgensen, Søren Solgaard, Anne Grete

Kjersgaard, Henrik Kehlet

Department of Orthopaedic Surgery, Copenhagen University Hospital Bispebjerg;

Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track Hip

and Knee Arthroplasty, Copenhagen Unversity Hospital Rigshospitalet; Department

of Orthopaedic Surgery, Copenhagen University Hospital Gentofte; Department of

Orthopaedic Surgery, Copenhagen University Hospital Gentofte; Section of Surgical

Pathophysiology and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty,

Copenhagen University Hospital Rigshospitalet

Background:

The use of uncemented fixation in total hip arthroplasty (THA) is increas-

ing. Register studies have suggested an increased risk of revision of uncemented implants

due to early periprosthetic femoral fractures.

Purpose / Aim of Study:

To describe the incidence, consequences and potential risk

factors associated with intra- and early postoperative (¡Ü 90 days) periprosthetic femo-

ral fractures after THA.

Materials and Methods:

Observational prospective study in 8 dedicated high-volume

centers from February 2010 to November 2013. 90- days follow-up from the Danish

Patient Registry and patient records. Intraoperative information from the Danish Hip

Arthroplasty Register and surgical notes.

Findings / Results:

In 7169 primary THA, 5482 (76.5%) were performed using unce-

mented femoral components. The total incidence of periprosthetic femoral fractures ¡Ü

90 days postoperatively was 2.1% (n=150). 70 (1.0%) fractures were intraoperative

(46 required osteosynthesis and 14 limited weight bearing), 51 (0.7%) postoperative

fractures occurred without trauma (42 re-operated) and 29 (0.4%) were postoperative

fall-related fractures (27 re-operated). 134 (2.4%) fractures were found in uncemented

vs 16 (0.9%) in cemented femoral components (p<0.001). 1674 (55.0%) uncemented

femoral components were implanted in patients >70 years with a fracture incidence of

3.3% (n=56) vs 0.8% (n=11) in cemented components (p<0.001). Uncemented femoral

component (OR 4.7, p<0.001), medically treated osteoporosis (OR 3.9, p<0.001) and

female gender (OR 1.9, p=0.027) were associated with increased risk of periprosthetic

femoral fracture in patients >70 years when analysed using multiple logistic regression.

Conclusions:

Uncemented femoral components may increase the risk of early peripros-

thetic femoral fractures, especially in the elderly, osteoporotic and female patients.

No conflicts of interest reported

132.