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Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component

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AIMS: The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana).

PATIENTS AND METHODS: A total of 1598 consecutive hips, in 1441 patients receiving primary THA between January 2010 and June 2015, were retrospectively identified. Level of pre-operative osteoarthritis, femoral Dorr type and cortical index were recorded. Varus/valgus placement of the stem and canal fill ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture.

RESULTS: The mean follow-up was 713 days (1 to 2058). A total of 48 periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near significant two times increased risk over time for post-operative fracture.

CONCLUSION: Dorr type C is an independent risk factor for early periprosthetic fracture, following THA using a double tapered cementless stem such as the Bi-Metric. Surgeons should take bone morphology into consideration when planning for primary THA and consider using cemented femoral components in female patients with poor bone quality. Cite this article: Bone Joint J 2017;99-B:451-7.

Original languageEnglish
JournalThe bone & joint journal
Issue number4
Pages (from-to)451-457
Publication statusPublished - 4 Jun 2017

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Cementation, Female, Femoral Fractures, Follow-Up Studies, Hip Prosthesis, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Osteoarthritis, Hip, Periprosthetic Fractures, Prosthesis Design, Radiography, Retrospective Studies, Risk Factors, Sex Factors, Treatment Outcome, Young Adult, Journal Article

ID: 50269201