Using modular fluted tapered stem for management of periprosthetic femoral fracture in revision hip arthroplasty
Notice bibliographique
Résumé
Objective To evaluate the technique and clinical results of the modular fluted tapered stems for treating periprosthetic femoral fractures in revision hip arthroplasty. Methods From August 2007 to February 2014, fourteen patients (14 hips) with periprosthetic femoral fractures underwent revision hip arthroplasty with modular fluted tapered stem. A retrospective analysis was performed involving all patients who were followed-up more than 2 years. The subjects consisted of 4 males and 10 females with mean age of 73.4±6.6 years (range, 62-82 years) at the time of revision. All patients were unilateral with 8 left hips and 6 right hips. The status of primary arthroplasty was bipolar hemiarthroplasty in 3 patients and total hip arthroplasty in 11 patients. Nine cases were with cemented stems, 5 cases with uncemented stems. The interval from primary hip arthroplasty to revision surgery ranged from 40 to 163 months, with an average of 120.9±31.9 months. Eight cases with Vancouver type B3 periprosthetic femoral fracture were found preoperatively, 6 cases with aseptic loosening and bone deficiency occurred periprosthetic femoral fracture during the operation. Based on the Paprosky classification system for femoral bone deficiency: type IIIA in 8 hips, type IIIB in 5 hips, type IV in 1 hip. Both the femoral and the acetabular components were revised in 9 patients. All femoral fractures were treated with cable fixation, and the cortical allograft struts were used to augment femoral bone stock in 7 patients. The patients were followed up at 6 weeks, 3 months, 6 months, 9 months, 12 months and annually thereafter. Harris Hip Score System and radiographic examination was used to evaluate the clinical results, including fracture union, implant stability, bone stock, hip joint function and postoperative complications. Results The mean duration of follow-up was 62.1±22.2 months (range, 30-96 months). The mean times of fracture union were 6.2±2.5 months (range, 3-12 months). The Harris Hip Score improved from 29.6±10.3 preoperatively to 86.3±4.2 postoperatively (t=-21.6, P=0.00). Thirteen cases (93%, 13/14) had the stem subsidence of 4.9±2.5 mm (range, 0-9 mm). Thirteen cases (93%, 13/14) were presented with femoral bony restoration. Two cases showed incorporation of the allograft in 7 patients. One patient developed deep venous thrombosis of lower limbs, and one suffered from subcutaneous hematomas after surgery. There was no infection, aseptic loosening, dislocation or periprosthetic fracture complications at the follow-up. Conclusion The short-medium term results of the modular fluted tapered prosthesis applied in periprosthetic femoral fractures are encouraging in revision hip arthroplasty. The present technology can provide reliable primary stability and can tolerate minimal subsidence postoperatively. Key words: Arthroplasty, replacement, hip; Reoperation; Femoral fractures; Hip prosthesis
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».