6/29/2023 0 Comments Acetabular fractureA marker was used to quantify the magnification of all radiographs. Radiological evaluation was carried out on standard preoperative and postoperative (on the second postoperative day) anteroposterior radiographs. IFF data were collected from medical records and by evaluation of radiographs. Posterolateral and direct lateral surgical approaches were used with the patient in lateral decubitus position with a cushion between the legs.ĭata for sex, age, weight, height, and comorbidities were obtained from medical records. The decision of whether to use the SP-CL ® implant was made by the operating orthopedic surgeon based on the patient’s age, fragility, bone morphology, comorbidities, and activity level. The medical center has previous experience with Zweymüller and uncemented Müller-type implants from different companies since the year 1997. The data were collected retrospectively from local hospital records and from the national electronic medical database. The aim of the current study is to analyze the intraoperative complications and assess the risk factors for IFF in THA using the SP-CL ® implant.Īll THA patients who were operated using the SP-CL ® (LINK, Hamburg, Germany) CaP-coated implant at Tartu University Hospital between 20 were included in this study. Ī novel cementless femoral implant (SP-CL ®) has been developed, offering several new features that might improve the outcome of THA: (1) grooves in the proximal part of the stem to provide early rotational stability, (2) an anatomic S-shape of the implant that decreases the morphometric mismatch with the proximal femur, (3) a CaP coating on the proximal two-thirds to provides osseointegration for secondary stability, and (4) a polished tip of the implant to allow gliding in the medullary canal, which does not cause stress risers and might decrease the incidence of thigh pain. Since IFF lead to poorer functional outcomes and decreased patient satisfaction, it is important to identify the risk group and avoid complications. IFF occur most often at calcar, greater trochanter, and femoral diaphysis. Thus, thorough preparation of the femoral canal and correct sizing and fitting of the implant are of utmost importance to ensure the longevity of the implant. In THA using cementless implants, the geometrical fit of the implant is essential to achieve good primary stability. One of the concerns related to the use of cementless implants in THA is the increased risk of intraoperative femoral fracture. Cementless implants have also increasingly been used among the elderly population, which should not be encouraged because of the higher complication rate. The growing use of cementless implants has been shown to improve the survival rate in younger patients. Aseptic loosening is the major reason for revision after THA. Since global trends show an increase in THA in this younger age group, it is crucial to avoid complications and improve implant survival. One of the most problematic groups among the THA population is younger patients, whose lifetime risk of revision is up to 35% compared with 5% for patients aged over 70 years. ![]() Nevertheless, there are complications that can lead to revision surgery. Total hip arthroplasty (THA) has been claimed to be the operation of the century due to its excellent results. The radiographic morphology of the proximal femur was an important predictor of IFF and should be assessed when using SP-CL ®. The results of the current study demonstrate a 5% incidence of IFF when using the LINK SP-CL ® femoral stem in THA. The radiographic morphology of proximal femur was associated with increased risk of IFF ( p = 0.02). ![]() None of the IFF patients were revised due to fracture during the follow-up period (one revision due to infection). There were 1 transient sciatic nerve injury, 1 acetabular fracture, and 11 (5.0%) intraoperative femoral fractures (IFF), of which 7 were treated with cerclage wire or titanium band during the operation while the other fractures were treated conservatively. The average age of the patients was 56 years (14–77 years). ResultsĪ total of 222 THA were performed using the SP-CL ® implant. Radiological measurements were made from standard pre- and postoperative radiographs. Data were collected from medical records from national and hospital electronic databases. Materials and methodsĪll THA patients who were operated on using the SP-CL ® (LINK, Hamburg, Germany) implant between 20 were included in the analysis. The aim of this study is to evaluate intraoperative complications and assess the risk factors of THA with the SP-CL ® implant. ![]() A new cementless femoral stem, SP-CL ®, has been introduced. Considering the excellent results already achieved in total hip arthroplasty (THA), new implants must be at least as safe as currently used implants and lead to longer survival.
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