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Arun Kumar - One of the best experts on this subject based on the ideXlab platform.
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Periprosthetic Fractures of the femur after total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2010Co-Authors: Phil Mcgraw, Arun KumarAbstract:Periprosthetic Fracture following total knee arthroplasty is a potentially serious complication. This injury can involve the distal femur, proximal tibia or the patella. This review article analyzes the prevalence, risk factors, classification and treatment options for Periprosthetic Fractures of the femur.
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Periprosthetic Fracture of the proximal tibia after lateral unicompartmental knee arthroplasty
The Journal of arthroplasty, 2007Co-Authors: Arun Kumar, Iain Chambers, Paul WongAbstract:We report a case of Periprosthetic Fracture of the proximal tibia after lateral unicompartmental knee arthroplasty following a trivial fall. At the time of surgery, the components were found to be loose; and there was a large uncontained tibial defect with bone loss and communition at the Fracture site. The patient was treated by revision total knee arthroplasty and proximal structural tibial allograft, with a satisfactory result at 5-year follow up. Our case illustrates that a bone-conserving unicompartmental knee arthroplasty, if complicated by a Periprosthetic Fracture, can also present with a difficult surgical problem. Attention to preoperative planning and to availability of structural allograft for such difficult cases is recommended.
Goran Garellick - One of the best experts on this subject based on the ideXlab platform.
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the excess mortality due to Periprosthetic femur Fracture a study from the swedish national hip arthroplasty register
Bone, 2007Co-Authors: Hans Lindahl, Goran Garellick, Anders Oden, Henrik MalchauAbstract:A rare but serious adverse event of total hip replacement (THR) is Periprosthetic femoral Fracture. The aim of the present study was to assess whether there was an excess mortality due to such a Fracture and to estimate the probability of death caused by the Fracture. We studied primary total hip replacement in 27,652 men and 35,930 women with osteoarthritis from The Swedish National Hip Arthroplasty Register operated from 1979 to 2000. From the same register we also studied 392 men and 344 women with Periprosthetic Fracture from 1979 to 2000, all with osteoarthritis as the primary diagnosis. By the special method applied, it was possible to perform the estimation of death due to the Fracture event though we could not determine in the individual case whether the Fracture caused the death. Compared to the total population of patients operated with a primary THR there was a higher mortality rate immediately after the surgery for patients with Periprosthetic Fracture and in the longer run for patients below the age of 70 years. At the age of 70 years the estimated probability of death due to the Fracture was 2.1% for men and 1.2% for women. At the age of 80 years at Fracture the corresponding probabilities were 3.9% and 2.2% for men and women, respectively.
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risk factors for failure after treatment of a Periprosthetic Fracture of the femur
Journal of Bone and Joint Surgery-british Volume, 2006Co-Authors: Hans Lindahl, Henrik Malchau, Anders Oden, Goran GarellickAbstract:Periprosthetic Fracture of the femur is an uncommon complication after total hip replacement, but appears to be increasing. We undertook a nationwide observational study to determine the risk factors for failure after treatment of these Fractures, examining patient- and implant-related factors, the classification of the Fractures and the outcome. Between 1979 and 2000, 1049 Periprosthetic Fractures of the femur were reported to the Swedish National Hip Arthroplasty Register. Of these, 245 had a further operation after failure of their initial management. Data were collected from the Register and hospital records. The material was analysed by the use of Poisson regression models. It was found that the risk of failure of treatment was reduced for Vancouver type B2 injuries (p = 0.0053) if revision of the implant was undertaken (p = 0.0033) or revision and open reduction and internal fixation (p = 0.0039) were performed. Fractures classified as Vancouver type B1 had a significantly higher risk of failure (p = 0.0001). The strongest negative factor was the use of a single plate for fixation (p = 0.001). The most common reasons for failure in this group were loosening of the femoral prosthesis, nonunion and re-Fracture. It is probable that many Fractures classified as Vancouver type B1 (n = 304), were in reality type B2 Fractures with a loose stem which were not recognised. Plate fixation was inadequate in these cases. The difficulty in separating type B1 from type B2 Fractures suggests that the prosthesis should be considered as loose until proven otherwise.
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Periprosthetic femoral Fractures classification and demographics of 1049 Periprosthetic femoral Fractures from the swedish national hip arthroplasty register
Journal of Arthroplasty, 2005Co-Authors: Hans Lindahl, Henrik Malchau, Peter Herberts, Goran GarellickAbstract:Postoperative femoral Periprosthetic Fracture is an uncommon complication of total hip arthroplasty surgery, but several centers worldwide have recently reported an increase in total numbers of such Fractures. This severe complication is costly for society and results in high morbidity. Our analysis of 1049 Periprosthetic Fractures occurring in Sweden between 1979 and 2000 and recorded in the Swedish National Hip Arthroplasty Register focuses on patient- and implant-related factors, Fracture classification, and Fracture frequency. These were our 3 major findings: (1) a majority of the patients who sustained a late Periprosthetic femoral Fracture had a loose stem. (2) Implant-related factors are significantly associated with occurrence of a Periprosthetic Fracture. (3) Since the 1980s in Sweden, treatment results for Periprosthetic Fractures have been poor, with low long-term survivorship and a high frequency of complications. We have initiated further studies of this important problem.
Henrik Malchau - One of the best experts on this subject based on the ideXlab platform.
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the excess mortality due to Periprosthetic femur Fracture a study from the swedish national hip arthroplasty register
Bone, 2007Co-Authors: Hans Lindahl, Goran Garellick, Anders Oden, Henrik MalchauAbstract:A rare but serious adverse event of total hip replacement (THR) is Periprosthetic femoral Fracture. The aim of the present study was to assess whether there was an excess mortality due to such a Fracture and to estimate the probability of death caused by the Fracture. We studied primary total hip replacement in 27,652 men and 35,930 women with osteoarthritis from The Swedish National Hip Arthroplasty Register operated from 1979 to 2000. From the same register we also studied 392 men and 344 women with Periprosthetic Fracture from 1979 to 2000, all with osteoarthritis as the primary diagnosis. By the special method applied, it was possible to perform the estimation of death due to the Fracture event though we could not determine in the individual case whether the Fracture caused the death. Compared to the total population of patients operated with a primary THR there was a higher mortality rate immediately after the surgery for patients with Periprosthetic Fracture and in the longer run for patients below the age of 70 years. At the age of 70 years the estimated probability of death due to the Fracture was 2.1% for men and 1.2% for women. At the age of 80 years at Fracture the corresponding probabilities were 3.9% and 2.2% for men and women, respectively.
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Mortality After Periprosthetic Fracture of the Femur
The Journal of bone and joint surgery. American volume, 2007Co-Authors: Timothy Bhattacharyya, Denis Chang, James B. Meigs, Daniel M. Estok, Henrik MalchauAbstract:Background: Management of Periprosthetic femoral Fractures is often complex, and few studies have documented its associated mortality. Methods: We retrospectively identified from our trauma and surgical registries 106 patients who underwent surgery for a Periprosthetic femoral Fracture. We then identified a contemporaneous age and sex-matched control cohort of 309 patients who had a hip Fracture (femoral neck or intertrochanteric) and 311 patients who underwent primary hip or knee replacement. Mortality at one year was identified with use of the Social Security database. Results: Twelve (11%) of 106 patients died within one year following surgical treatment of a Periprosthetic Fracture. During the same follow-up period, fifty-one (16.5%) of 309 patients died following surgery for a hip Fracture and nine (2.9%) of 311 patients died following primary joint replacement. The mortality rate after a Periprosthetic femoral Fracture was significantly higher (p < 0.0001) compared with that for matched patients who had undergone primary joint replacement, and it was similar to the mortality rate after a hip Fracture. For Periprosthetic Fractures, a delay of greater than two days from admission to the time of surgery was associated with an increased mortality rate at one year (p < 0.0007). Forty-nine patients underwent revision arthroplasty for the treatment of a Vancouver type-B Periprosthetic Fracture, and six (12%) died. In contrast, twenty-four patients with a Vancouver type-B Periprosthetic Fracture were treated with open reduction and internal fixation and eight (33%) died. The difference was significant (p < 0.03). Conclusions: The mortality rate within one year following surgical treatment of Periprosthetic femoral Fractures is high and is similar to that after treatment for hip Fractures. Because revision arthroplasty for the treatment of type-B Periprosthetic Fractures was associated with a one-year mortality rate that was significantly less than that after surgical treatment with open reduction and internal fixation, in instances when either treatment option is feasible, revision arthroplasty may be the preferred option. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
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risk factors for failure after treatment of a Periprosthetic Fracture of the femur
Journal of Bone and Joint Surgery-british Volume, 2006Co-Authors: Hans Lindahl, Henrik Malchau, Anders Oden, Goran GarellickAbstract:Periprosthetic Fracture of the femur is an uncommon complication after total hip replacement, but appears to be increasing. We undertook a nationwide observational study to determine the risk factors for failure after treatment of these Fractures, examining patient- and implant-related factors, the classification of the Fractures and the outcome. Between 1979 and 2000, 1049 Periprosthetic Fractures of the femur were reported to the Swedish National Hip Arthroplasty Register. Of these, 245 had a further operation after failure of their initial management. Data were collected from the Register and hospital records. The material was analysed by the use of Poisson regression models. It was found that the risk of failure of treatment was reduced for Vancouver type B2 injuries (p = 0.0053) if revision of the implant was undertaken (p = 0.0033) or revision and open reduction and internal fixation (p = 0.0039) were performed. Fractures classified as Vancouver type B1 had a significantly higher risk of failure (p = 0.0001). The strongest negative factor was the use of a single plate for fixation (p = 0.001). The most common reasons for failure in this group were loosening of the femoral prosthesis, nonunion and re-Fracture. It is probable that many Fractures classified as Vancouver type B1 (n = 304), were in reality type B2 Fractures with a loose stem which were not recognised. Plate fixation was inadequate in these cases. The difficulty in separating type B1 from type B2 Fractures suggests that the prosthesis should be considered as loose until proven otherwise.
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Periprosthetic femoral Fractures classification and demographics of 1049 Periprosthetic femoral Fractures from the swedish national hip arthroplasty register
Journal of Arthroplasty, 2005Co-Authors: Hans Lindahl, Henrik Malchau, Peter Herberts, Goran GarellickAbstract:Postoperative femoral Periprosthetic Fracture is an uncommon complication of total hip arthroplasty surgery, but several centers worldwide have recently reported an increase in total numbers of such Fractures. This severe complication is costly for society and results in high morbidity. Our analysis of 1049 Periprosthetic Fractures occurring in Sweden between 1979 and 2000 and recorded in the Swedish National Hip Arthroplasty Register focuses on patient- and implant-related factors, Fracture classification, and Fracture frequency. These were our 3 major findings: (1) a majority of the patients who sustained a late Periprosthetic femoral Fracture had a loose stem. (2) Implant-related factors are significantly associated with occurrence of a Periprosthetic Fracture. (3) Since the 1980s in Sweden, treatment results for Periprosthetic Fractures have been poor, with low long-term survivorship and a high frequency of complications. We have initiated further studies of this important problem.
Hans Lindahl - One of the best experts on this subject based on the ideXlab platform.
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the excess mortality due to Periprosthetic femur Fracture a study from the swedish national hip arthroplasty register
Bone, 2007Co-Authors: Hans Lindahl, Goran Garellick, Anders Oden, Henrik MalchauAbstract:A rare but serious adverse event of total hip replacement (THR) is Periprosthetic femoral Fracture. The aim of the present study was to assess whether there was an excess mortality due to such a Fracture and to estimate the probability of death caused by the Fracture. We studied primary total hip replacement in 27,652 men and 35,930 women with osteoarthritis from The Swedish National Hip Arthroplasty Register operated from 1979 to 2000. From the same register we also studied 392 men and 344 women with Periprosthetic Fracture from 1979 to 2000, all with osteoarthritis as the primary diagnosis. By the special method applied, it was possible to perform the estimation of death due to the Fracture event though we could not determine in the individual case whether the Fracture caused the death. Compared to the total population of patients operated with a primary THR there was a higher mortality rate immediately after the surgery for patients with Periprosthetic Fracture and in the longer run for patients below the age of 70 years. At the age of 70 years the estimated probability of death due to the Fracture was 2.1% for men and 1.2% for women. At the age of 80 years at Fracture the corresponding probabilities were 3.9% and 2.2% for men and women, respectively.
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risk factors for failure after treatment of a Periprosthetic Fracture of the femur
Journal of Bone and Joint Surgery-british Volume, 2006Co-Authors: Hans Lindahl, Henrik Malchau, Anders Oden, Goran GarellickAbstract:Periprosthetic Fracture of the femur is an uncommon complication after total hip replacement, but appears to be increasing. We undertook a nationwide observational study to determine the risk factors for failure after treatment of these Fractures, examining patient- and implant-related factors, the classification of the Fractures and the outcome. Between 1979 and 2000, 1049 Periprosthetic Fractures of the femur were reported to the Swedish National Hip Arthroplasty Register. Of these, 245 had a further operation after failure of their initial management. Data were collected from the Register and hospital records. The material was analysed by the use of Poisson regression models. It was found that the risk of failure of treatment was reduced for Vancouver type B2 injuries (p = 0.0053) if revision of the implant was undertaken (p = 0.0033) or revision and open reduction and internal fixation (p = 0.0039) were performed. Fractures classified as Vancouver type B1 had a significantly higher risk of failure (p = 0.0001). The strongest negative factor was the use of a single plate for fixation (p = 0.001). The most common reasons for failure in this group were loosening of the femoral prosthesis, nonunion and re-Fracture. It is probable that many Fractures classified as Vancouver type B1 (n = 304), were in reality type B2 Fractures with a loose stem which were not recognised. Plate fixation was inadequate in these cases. The difficulty in separating type B1 from type B2 Fractures suggests that the prosthesis should be considered as loose until proven otherwise.
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Periprosthetic femoral Fractures classification and demographics of 1049 Periprosthetic femoral Fractures from the swedish national hip arthroplasty register
Journal of Arthroplasty, 2005Co-Authors: Hans Lindahl, Henrik Malchau, Peter Herberts, Goran GarellickAbstract:Postoperative femoral Periprosthetic Fracture is an uncommon complication of total hip arthroplasty surgery, but several centers worldwide have recently reported an increase in total numbers of such Fractures. This severe complication is costly for society and results in high morbidity. Our analysis of 1049 Periprosthetic Fractures occurring in Sweden between 1979 and 2000 and recorded in the Swedish National Hip Arthroplasty Register focuses on patient- and implant-related factors, Fracture classification, and Fracture frequency. These were our 3 major findings: (1) a majority of the patients who sustained a late Periprosthetic femoral Fracture had a loose stem. (2) Implant-related factors are significantly associated with occurrence of a Periprosthetic Fracture. (3) Since the 1980s in Sweden, treatment results for Periprosthetic Fractures have been poor, with low long-term survivorship and a high frequency of complications. We have initiated further studies of this important problem.
Weiming Chen - One of the best experts on this subject based on the ideXlab platform.
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Periprosthetic femoral supracondylar Fracture after total knee arthroplasty with navigation system
Journal of Arthroplasty, 2008Co-Authors: Tainhsiung Chen, Pochou Shao, Kungsheng Lee, Weiming ChenAbstract:We report 1 patient with a supracondylar Periprosthetic Fracture 1 month after computer-assisted total knee arthroplasty. The Fracture line extended from previous anchoring pinholes into the supracondyle area. Intramedullary nailing of the left femur was performed under close reduction. The possible complication of pinhole Fracture to total knee arthroplasty with navigation system should be kept in mind.