The insidious risk of periprosthetic fracture in clinically functional total hip arthroplasties: A biomechanical study of willed joints - PubMed (original) (raw)

. 2022 Aug;40(8):1943-1952.

doi: 10.1002/jor.25203. Epub 2021 Nov 2.

Affiliations

Free article

The insidious risk of periprosthetic fracture in clinically functional total hip arthroplasties: A biomechanical study of willed joints

Karren M Takamura et al. J Orthop Res. 2022 Aug.

Free article

Abstract

Femoral bone quality is a major risk factor of periprosthetic fracture after total hip arthroplasty (THA), which has mortality similar to native hip fractures but higher short-term morbidity. The goal of this study was to quantify cortical strains at the site of expected Vancouver Type-B periprosthetic fracture as a function of bone mineral density, femoral stem material, and fixation method using a series of 29 autopsy-retrieved, clinically asymptomatic hip joints with THA. Periprosthetic bone mineral content and density was assessed using dual-energy X-ray absorptiometry by Gruen Zone. Specimens then underwent combined cyclic axial and torsional loading, increasing incrementally from 100 N and ±1 Nm to peaks of 700 N and ±5 Nm. All specimens experienced significantly higher strains on the lateral surface than on the anterior surface, indicating that the bending loads in the frontal plane, rather than axial/torsional loads, had the predominant effect. Multiple significant relationships (p = 0.04, p = 0.02) were found between predicted periprosthetic strains calculated from radiographic measurements and observed principal strains. Though THA in the present study were in successful clinical service, the produced results indicated that some femurs with rigid cemented or noncemented implants were potentially at high risk for Vancouver Type-B fractures, which may be predicted radiographically.

Keywords: arthroplasty; biomechanics; fracture; hip; periprosthetic.

© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.

PubMed Disclaimer

References

REFERENCES

    1. Biggi F, Di Fabio S, D'Antimo C, Trevisani S. Periprosthetic fractures of the femur: the stability of the implant dictates the type of treatment. J Orthopaed Traumatol. 2010;11:1-5.
    1. Maradit Kremers H, Larson DR, Crowson CS, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97:1386-1397.
    1. Ackerman IN, Bohensky MA, Zomer E, et al. The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030. BMC Musculoskelet Disord. 2019;20:90.
    1. Kärrholm J, Lindahl H, Malchau H, et al. The Swedish Hip Arthroplasty Register Annual Report 2016; 2016.
    1. Graves S. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee Shoulder Arthroplasty: 2018 Annual Report; 2018.

Publication types

MeSH terms

LinkOut - more resources