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...
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doaj-be3113b3573648a3a458f72564f0853f2021-08-12T04:34:50ZengElsevierArthroplasty Today2352-34412021-10-01111014Novel Cemented Technique for Trochanteric Fixation and Reconstruction of the Abductor Mechanism in Proximal and Total Femoral Arthroplasty: An Observational StudyBrian T. Muffly, MD0Kyle T. Boden, MD1Cale A. Jacobs, PhD2Patrick W. O’Donnell, MD, PhD3Stephen T. Duncan, MD4Corresponding author. 654 Montclair Dr, Lexington, KY 40502, USA. Tel.: +1-606-304-3987.; Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USABackground: 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.http://www.sciencedirect.com/science/article/pii/S2352344121001060Abductor reconstructionFemoral endoprosthesisMegaprosthesisGreater trochanterReconstruction |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Brian T. Muffly, MD Kyle T. Boden, MD Cale A. Jacobs, PhD Patrick W. O’Donnell, MD, PhD Stephen T. Duncan, MD |
spellingShingle |
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 Arthroplasty Today Abductor reconstruction Femoral endoprosthesis Megaprosthesis Greater trochanter Reconstruction |
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 |
series |
Arthroplasty Today |
issn |
2352-3441 |
publishDate |
2021-10-01 |
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. |
topic |
Abductor reconstruction Femoral endoprosthesis Megaprosthesis Greater trochanter Reconstruction |
url |
http://www.sciencedirect.com/science/article/pii/S2352344121001060 |
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