Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?
Abstract Background The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-05502-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571425573044224 |
|---|---|
| author | Matthias Luger Sandra Feldler Manuel Gahleitner Lorenz Pisecky Tobias Gotterbarm Christian Stadler |
| author_facet | Matthias Luger Sandra Feldler Manuel Gahleitner Lorenz Pisecky Tobias Gotterbarm Christian Stadler |
| author_sort | Matthias Luger |
| collection | DOAJ |
| description | Abstract Background The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index. Therefore, this study aims to compare the femoral and pelvic geometry in PFFs between short stem and straight stem THA. Methods A retrospective comparative propensity-score matched study was performed. An institutional database of 5358 THAs was screened for early PFFs within the first 90 days after surgery. All cases of 136 PFFs in primary cementless THA were collected and matched, resulting in 67 PFFs in the straight stem and 37 PFFs in the short stem group. Both groups were analyzed regarding several parameters for femoral and pelvic morphology. Results A significantly lower distance from the anterior superior iliac spine to the greater trochanter (AGT) was detected in the straight stem group (96.4 vs. 104.8 mm, p = 0.024). All other femoral and pelvic parameters did not differ between both groups. Postoperative Vancouver A PFFs were significantly higher in straight stem THA, while postoperative Vancouver B PFFs were significantly higher in short stem THA. Conclusion The morphology of the proximal femur and the pelvis do not differ in several radiological parameters in patients sustaining a PFF between cementless short stem implanted via an anterolateral approach and straight stem THA implanted via a transgluteal approach. While there are differences in the Vancouver types of PFFs, these differences do not reflect any difference in the morphology of the proximal femur and the pelvis. |
| format | Article |
| id | doaj-art-165fb98bc42d4ea7847eaa00b79cca5a |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-165fb98bc42d4ea7847eaa00b79cca5a2025-02-02T12:34:16ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111510.1186/s13018-025-05502-yPeriprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?Matthias Luger0Sandra Feldler1Manuel Gahleitner2Lorenz Pisecky3Tobias Gotterbarm4Christian Stadler5Department for Orthopedics and Traumatology, Kepler University Hospital GmbHDepartment for Orthopedics and Traumatology, Kepler University Hospital GmbHDepartment for Orthopedics and Traumatology, Kepler University Hospital GmbHDepartment for Orthopedics and Traumatology, Kepler University Hospital GmbHDepartment for Orthopedics and Traumatology, Kepler University Hospital GmbHDepartment for Orthopedics and Traumatology, Kepler University Hospital GmbHAbstract Background The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index. Therefore, this study aims to compare the femoral and pelvic geometry in PFFs between short stem and straight stem THA. Methods A retrospective comparative propensity-score matched study was performed. An institutional database of 5358 THAs was screened for early PFFs within the first 90 days after surgery. All cases of 136 PFFs in primary cementless THA were collected and matched, resulting in 67 PFFs in the straight stem and 37 PFFs in the short stem group. Both groups were analyzed regarding several parameters for femoral and pelvic morphology. Results A significantly lower distance from the anterior superior iliac spine to the greater trochanter (AGT) was detected in the straight stem group (96.4 vs. 104.8 mm, p = 0.024). All other femoral and pelvic parameters did not differ between both groups. Postoperative Vancouver A PFFs were significantly higher in straight stem THA, while postoperative Vancouver B PFFs were significantly higher in short stem THA. Conclusion The morphology of the proximal femur and the pelvis do not differ in several radiological parameters in patients sustaining a PFF between cementless short stem implanted via an anterolateral approach and straight stem THA implanted via a transgluteal approach. While there are differences in the Vancouver types of PFFs, these differences do not reflect any difference in the morphology of the proximal femur and the pelvis.https://doi.org/10.1186/s13018-025-05502-yPeriprosthetic femoral fracturePeriprosthetic fractureTotal hip arthroplastyShort stemCementlessStraight stem |
| spellingShingle | Matthias Luger Sandra Feldler Manuel Gahleitner Lorenz Pisecky Tobias Gotterbarm Christian Stadler Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? Journal of Orthopaedic Surgery and Research Periprosthetic femoral fracture Periprosthetic fracture Total hip arthroplasty Short stem Cementless Straight stem |
| title | Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? |
| title_full | Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? |
| title_fullStr | Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? |
| title_full_unstemmed | Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? |
| title_short | Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology? |
| title_sort | periprosthetic femoral fractures in minimally invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty what are the differences in the femoral and pelvic morphology |
| topic | Periprosthetic femoral fracture Periprosthetic fracture Total hip arthroplasty Short stem Cementless Straight stem |
| url | https://doi.org/10.1186/s13018-025-05502-y |
| work_keys_str_mv | AT matthiasluger periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology AT sandrafeldler periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology AT manuelgahleitner periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology AT lorenzpisecky periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology AT tobiasgotterbarm periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology AT christianstadler periprostheticfemoralfracturesinminimallyinvasiveanterolateralshortstemversustransglutealstraightstemcementlesstotalhiparthroplastywhatarethedifferencesinthefemoralandpelvicmorphology |