Periprosthetic fragility fracture of the femur after primary cementless total hip arthroplasty

Mod Rheumatol. 2022 Apr 18;32(3):626-633. doi: 10.1093/mr/roab025.

Abstract

Objectives: Periprosthetic bone fragility due to stress shielding (SS) can be a risk factor of periprosthetic fracture after cementless total hip arthroplasty (THA). We aimed to obtain epidemiological information on periprosthetic fragility fracture of the femur (PPFF) after THA.

Methods: We retrospectively reviewed the medical records of 1062 hips that had undergone cementless THA. We evaluated the epidemiological data as well as the features of PPFFs.

Results: Of the 1062 hips, 8 (0.8%) were diagnosed with PPFFs. The survival rates, with the occurrence of PPFF as the end point, were 99.2% and 97.6% at 10 and 16 years postoperatively, respectively. When patients were classified as having either mild or severe SS on radiographs 5 years postoperatively, there was no significant difference in the survival rate, with PPFF as the end point.

Conclusions: In our cases, the incidence of PPFF after cementless THA was 0.8%.

Keywords: Bone remodelling; cementless stem; complication; fragility fracture; stress shielding.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Femur / surgery
  • Hip Prosthesis* / adverse effects
  • Humans
  • Periprosthetic Fractures* / diagnostic imaging
  • Periprosthetic Fractures* / epidemiology
  • Periprosthetic Fractures* / etiology
  • Reoperation
  • Retrospective Studies