Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study)
Background: Periprosthetic femoral fractures are challenging complications after total hip arthroplasty (THA) or bipolar hemiarthroplasty (BHA). This multicenter study compared clinical outcomes of surgical periprosthetic femoral fracture (PFF) treatment following initial implantation of cemented vs...
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Elsevier
2025-06-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235234412500086X |
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| author | Hiroaki Tachi, MD Yasuhiko Takegami, MD Toshiaki Okura, MD, PhD Katsuhiro Tokutake, MD, PhD Hiroaki Nakashima, MD, PhD Kenichi Mishima, MD, PhD Takehiro Kasai, MD, PhD Shiro Imagama, MD, PhD |
| author_facet | Hiroaki Tachi, MD Yasuhiko Takegami, MD Toshiaki Okura, MD, PhD Katsuhiro Tokutake, MD, PhD Hiroaki Nakashima, MD, PhD Kenichi Mishima, MD, PhD Takehiro Kasai, MD, PhD Shiro Imagama, MD, PhD |
| author_sort | Hiroaki Tachi, MD |
| collection | DOAJ |
| description | Background: Periprosthetic femoral fractures are challenging complications after total hip arthroplasty (THA) or bipolar hemiarthroplasty (BHA). This multicenter study compared clinical outcomes of surgical periprosthetic femoral fracture (PFF) treatment following initial implantation of cemented vs cementless femoral stems. Methods: This retrospective multicenter study included 201 patients from multiple hospitals who had PFFs treated surgically between 2010 and 2022. They were divided into THA (n = 71) and BHA (n = 130) cohorts based on initial arthroplasty. Clinical outcomes of mortality, radiographic bone union, operative metrics, and complications were compared after the patients were matched for age. Results: In the matched THA cohorts (n = 15 each), there were no significant differences in mortality, bone union, operative time, blood loss, or complications between cemented and cementless stems. In the matched BHA cohorts (n = 27 each), mortality and bone union were similar, but cementless stems showed higher intraoperative blood loss. Furthermore, Type B fractures were more common with cementless stems, whereas Type C fractures were predominated with cemented stems. Conclusions: Among patients who underwent THA or BHA, mortality and bone union following treatment of PFFs did not differ between cemented and cementless stems. However, patients who underwent BHA with cementless stems required longer operations and lost more blood. Type B fractures requiring revision occurred more frequently with cementless stems, whereas Type C fractures treated with open reduction and internal fixation were more frequent with cemented stems, which thus influenced perioperative factors. Cement use for initial arthroplasty was associated with certain favorable characteristics and positive treatment outcomes of PFFs. |
| format | Article |
| id | doaj-art-1a64c7e3c6e7408e8743a10033b8e1e8 |
| institution | Matheson Library |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-1a64c7e3c6e7408e8743a10033b8e1e82025-06-25T04:51:41ZengElsevierArthroplasty Today2352-34412025-06-0133101699Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study)Hiroaki Tachi, MD0Yasuhiko Takegami, MD1Toshiaki Okura, MD, PhD2Katsuhiro Tokutake, MD, PhD3Hiroaki Nakashima, MD, PhD4Kenichi Mishima, MD, PhD5Takehiro Kasai, MD, PhD6Shiro Imagama, MD, PhD7Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Orthopaedic Surgery, Konan Kosei Hospital, Aichi, Japan; Corresponding author. Department of Orthopaedic Surgery, Konan Kosei Hospital, 137 Ōmatsubara, Takayachō, Kōnan-shi, Aichi-ken 483-8704, Japan.Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Orthopaedic Surgery, Konan Kosei Hospital, Aichi, JapanDepartment of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanBackground: Periprosthetic femoral fractures are challenging complications after total hip arthroplasty (THA) or bipolar hemiarthroplasty (BHA). This multicenter study compared clinical outcomes of surgical periprosthetic femoral fracture (PFF) treatment following initial implantation of cemented vs cementless femoral stems. Methods: This retrospective multicenter study included 201 patients from multiple hospitals who had PFFs treated surgically between 2010 and 2022. They were divided into THA (n = 71) and BHA (n = 130) cohorts based on initial arthroplasty. Clinical outcomes of mortality, radiographic bone union, operative metrics, and complications were compared after the patients were matched for age. Results: In the matched THA cohorts (n = 15 each), there were no significant differences in mortality, bone union, operative time, blood loss, or complications between cemented and cementless stems. In the matched BHA cohorts (n = 27 each), mortality and bone union were similar, but cementless stems showed higher intraoperative blood loss. Furthermore, Type B fractures were more common with cementless stems, whereas Type C fractures were predominated with cemented stems. Conclusions: Among patients who underwent THA or BHA, mortality and bone union following treatment of PFFs did not differ between cemented and cementless stems. However, patients who underwent BHA with cementless stems required longer operations and lost more blood. Type B fractures requiring revision occurred more frequently with cementless stems, whereas Type C fractures treated with open reduction and internal fixation were more frequent with cemented stems, which thus influenced perioperative factors. Cement use for initial arthroplasty was associated with certain favorable characteristics and positive treatment outcomes of PFFs.http://www.sciencedirect.com/science/article/pii/S235234412500086XPeriprosthetic femoral fracturesOpen reduction internal fixationRevision arthroplastyCemented stem |
| spellingShingle | Hiroaki Tachi, MD Yasuhiko Takegami, MD Toshiaki Okura, MD, PhD Katsuhiro Tokutake, MD, PhD Hiroaki Nakashima, MD, PhD Kenichi Mishima, MD, PhD Takehiro Kasai, MD, PhD Shiro Imagama, MD, PhD Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) Arthroplasty Today Periprosthetic femoral fractures Open reduction internal fixation Revision arthroplasty Cemented stem |
| title | Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) |
| title_full | Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) |
| title_fullStr | Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) |
| title_full_unstemmed | Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) |
| title_short | Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) |
| title_sort | comparison of clinical outcomes of periprosthetic fractures between cemented vs cementless stem methods after initial total hip arthroplasty or bipolar hemiarthroplasty a multicenter analysis tron study |
| topic | Periprosthetic femoral fractures Open reduction internal fixation Revision arthroplasty Cemented stem |
| url | http://www.sciencedirect.com/science/article/pii/S235234412500086X |
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