![]() Additionally, the researchers reported an increased risk of PPF with cementless fixation for THA in female patients and those aged >65 years. ![]() Kelly remarked.Ĭomparing the incidence of subsequent revision or ORIF up to 96 months following primary THA, cementless patients had higher rates at all time points (Fig. “The sheer rate of cementless fixation and risk for periprosthetic fracture in this population in the United States was surprising, although not totally unexpected given anecdotal experience at our institutions,” Dr. Compared with cemented stems, patients with cementless stems had an increased risk of PPF. Of the total 279,054 primary THA cases with reported femoral stem fixation characteristics identified, 266,040 were cementless and 13,012 were cemented. While adjusting for potential confounders, they used Cox proportional hazard regression analysis with competing risk of death to evaluate the association of fixation and fracture risk. The authors collected patient demographics, then sorted the patients into cohorts based on whether they received a cementless or cemented femoral stem. Cases were linked to supplemental data from the Centers for Medicare & Medicaid Services (CMS) if available. They identified all primary THA procedures in patients aged >65 years. Kelly and coauthors analyzed American Joint Replacement Registry data from 2012 to 2020. healthcare system, we felt this would be an impactful study to illuminate current practices,” Dr. “As a complication demanding resources from the U.S. What inspired the study, according to lead author Mackenzie Kelly, MD, orthopaedic surgery resident at Oregon Health and Science University, was a curiosity regarding the use of cementless femoral stem fixation in the United States despite recent international registry data highlighting an increased risk of PFF in elderly patients. A study comparing the incidence of PPF between cemented and cementless femoral fixation in THA patients was presented at the AAOS 2023 Annual Meeting. There is mounting evidence that suggests an increased risk of PPF associated with cementless femoral stem fixation in elderly THA patients. ![]() Postoperative periprosthetic femur fractures (PPFs), severe complications following total hip arthroplasty (THA), present both a significant clinical and economic burden.
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