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Published on: March 11, 2017
Fracture of femoral prostheses in total hip replacement. A clinical study
Insights
This study found that heavier males are at higher risk for Charnley femoral prosthesis fractures. Improved cement techniques are crucial for preventing these fractures in hip replacement surgery.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Materials science
Background:
- The Charnley femoral prosthesis is a common implant used in hip replacement surgery.
- Fracture of the prosthesis can lead to significant patient morbidity and revision surgery.
- Understanding risk factors and causes of prosthesis failure is critical for improving patient outcomes.
Purpose of the Study:
- To analyze the clinical features of fractured Charnley femoral prostheses.
- To identify patient populations at higher risk for prosthesis fracture.
- To investigate the role of surgical technique in prosthesis failure.
Main Methods:
- Retrospective review of 17 fractured Charnley femoral prostheses.
- Analysis of clinical data from approximately 6,500 hip replacement surgeries.
- Follow-up period of over 3.5 years for all patients.
Main Results:
- An overall fracture rate of 0.23% was observed.
- Males weighing over 170 lb (75.5 kg) were identified as a high-risk group.
- The fracture rate for males over 196 lb (88 kg) was significantly higher at 6.0%.
Conclusions:
- A need for a heavier prosthesis design for at-risk patient groups.
- Defective surgical technique, specifically inadequate cement support, is a probable primary cause of fracture.
- Improved cement techniques are essential for reducing prosthesis fracture rates.
Abstract:
The clinical features are presented of 17 fractured Charnley femoral prostheses occurring over a period of about ten years and arising from some 6,500 operations, with more than a 3 1/2 year follow-up. The patients especially at risk are males weighing over 170 lb (75.5 kg) and from these is an obvious need for a heavier design of prosthesis. Whereas the overall fracture rate is only 0.23 per cent, the rate for males over 196 lb (88 kg) is 6.0 per cent. It is believed that defective surgical technique, in failing to provide adequate support by cement to the concavity of the upper levels of the prosthesis is probably the main cause of fracture and reasonably good cement technique explains why the fracture rate is not higher in the present series. Indications for improving cement technique are outlined.
