Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study

Background: Little evidence exists regarding the clinical outcomes of cemented trochanteric fixation for abductor mechanism reconstruction in proximal or total femoral replacements. Clinical outcomes were assessed for a novel cemented technique for trochanteric fixation in femoral megaprostheses. Me...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Brian T. Muffly, MD, Kyle T. Boden, MD, Cale A. Jacobs, PhD, Patrick W. O’Donnell, MD, PhD, Stephen T. Duncan, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Abductor reconstruction Femoral endoprosthesis Megaprosthesis Greater trochanter Reconstruction Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/be3113b3573648a3a458f72564f0853f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:be3113b3573648a3a458f72564f0853f
record_format	dspace
spelling	oai:doaj.org-article:be3113b3573648a3a458f72564f0853f2021-11-14T04:33:43ZNovel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study2352-344110.1016/j.artd.2021.06.009https://doaj.org/article/be3113b3573648a3a458f72564f0853f2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001060https://doaj.org/toc/2352-3441Background: Little evidence exists regarding the clinical outcomes of cemented trochanteric fixation for abductor mechanism reconstruction in proximal or total femoral replacements. Clinical outcomes were assessed for a novel cemented technique for trochanteric fixation in femoral megaprostheses. Methods: A descriptive series of 13 patients who underwent proximal or total femoral arthroplasty from 2016 to 2019 were reviewed. Radiographic trochanteric displacement >1 cm defined construct failure. A Kaplan-Meier survival analysis was performed to determine survival rates for these cemented constructs. Demographic information was obtained to better characterize the patient population in whom this technique was used. Results: Eleven patients were included (age = 63.6 years; 45.4% females; body mass index = 31.7). Mean time to final radiographic follow-up was 73.8 weeks. Three of 11 (27.2%) patients had construct failure. Overall, survival at 1 year was 81.8%. At 2 years, survival of cemented constructs was 65.5%. More construct failures occurred in patients who sustained a postoperative dislocation than in those who did not (P = .05). Conclusions: This novel cemented trochanteric fixation technique for reconstruction of the abductor mechanism in femoral megaprostheses had 81.8% survival at 1 year postoperatively. While longitudinal comparative studies with larger samples are needed, the cemented technique may provide a viable alternative to traditional cementless methods of trochanteric fixation. Increased construct failure rates after postoperative dislocation highlight the importance of robust abductor reconstruction in these implants.Brian T. Muffly, MDKyle T. Boden, MDCale A. Jacobs, PhDPatrick W. O’Donnell, MD, PhDStephen T. Duncan, MDElsevierarticleAbductor reconstructionFemoral endoprosthesisMegaprosthesisGreater trochanterReconstructionOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 10-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Abductor reconstruction Femoral endoprosthesis Megaprosthesis Greater trochanter Reconstruction Orthopedic surgery RD701-811
spellingShingle	Abductor reconstruction Femoral endoprosthesis Megaprosthesis Greater trochanter Reconstruction Orthopedic surgery RD701-811 Brian T. Muffly, MD Kyle T. Boden, MD Cale A. Jacobs, PhD Patrick W. O’Donnell, MD, PhD Stephen T. Duncan, MD Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
description	Background: Little evidence exists regarding the clinical outcomes of cemented trochanteric fixation for abductor mechanism reconstruction in proximal or total femoral replacements. Clinical outcomes were assessed for a novel cemented technique for trochanteric fixation in femoral megaprostheses. Methods: A descriptive series of 13 patients who underwent proximal or total femoral arthroplasty from 2016 to 2019 were reviewed. Radiographic trochanteric displacement >1 cm defined construct failure. A Kaplan-Meier survival analysis was performed to determine survival rates for these cemented constructs. Demographic information was obtained to better characterize the patient population in whom this technique was used. Results: Eleven patients were included (age = 63.6 years; 45.4% females; body mass index = 31.7). Mean time to final radiographic follow-up was 73.8 weeks. Three of 11 (27.2%) patients had construct failure. Overall, survival at 1 year was 81.8%. At 2 years, survival of cemented constructs was 65.5%. More construct failures occurred in patients who sustained a postoperative dislocation than in those who did not (P = .05). Conclusions: This novel cemented trochanteric fixation technique for reconstruction of the abductor mechanism in femoral megaprostheses had 81.8% survival at 1 year postoperatively. While longitudinal comparative studies with larger samples are needed, the cemented technique may provide a viable alternative to traditional cementless methods of trochanteric fixation. Increased construct failure rates after postoperative dislocation highlight the importance of robust abductor reconstruction in these implants.
format	article
author	Brian T. Muffly, MD Kyle T. Boden, MD Cale A. Jacobs, PhD Patrick W. O’Donnell, MD, PhD Stephen T. Duncan, MD
author_facet	Brian T. Muffly, MD Kyle T. Boden, MD Cale A. Jacobs, PhD Patrick W. O’Donnell, MD, PhD Stephen T. Duncan, MD
author_sort	Brian T. Muffly, MD
title	Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
title_short	Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
title_full	Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
title_fullStr	Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
title_full_unstemmed	Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study
title_sort	novel cemented technique for trochanteric fixation and reconstruction of the abductor mechanism in proximal and total femoral arthroplasty: an observational study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/be3113b3573648a3a458f72564f0853f
work_keys_str_mv	AT briantmufflymd novelcementedtechniquefortrochantericfixationandreconstructionoftheabductormechanisminproximalandtotalfemoralarthroplastyanobservationalstudy AT kyletbodenmd novelcementedtechniquefortrochantericfixationandreconstructionoftheabductormechanisminproximalandtotalfemoralarthroplastyanobservationalstudy AT caleajacobsphd novelcementedtechniquefortrochantericfixationandreconstructionoftheabductormechanisminproximalandtotalfemoralarthroplastyanobservationalstudy AT patrickwodonnellmdphd novelcementedtechniquefortrochantericfixationandreconstructionoftheabductormechanisminproximalandtotalfemoralarthroplastyanobservationalstudy AT stephentduncanmd novelcementedtechniquefortrochantericfixationandreconstructionoftheabductormechanisminproximalandtotalfemoralarthroplastyanobservationalstudy
_version_	1718429982912413696

Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational Study

Ejemplares similares