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Link to Read Complete Article
http://www.orthosupersite.com/view.asp?rID=25279
By Gina Brockenbrough December 2007
ORLANDO, Fla. — Although early periprosthetic femur fractures occurring after
total hip arthroplasty are considered rare, research now indicates an increase
in rates for some types of these fractures with current total hip arthroplasty
practices...
Daniel J. Berry, MD, and colleagues performed a database review of 7,612 primary
total hip arthroplasties (THAs) performed during a 10-year period and identified
periprosthetic femur fractures that occurred within 3 months after THA performed
using uncemented proximally coated stems...
The investigators found 28 Vancouver Type A1 fractures that had occurred an
average of 27 days postop, 11 of which were not associated with any episode of
trauma. Of the 28 patients who sustained an early postoperative fracture, 19
were using arm support to ambulate at the time of the fracture...
...'"It occurs with increased incidence right now, and I think that it is fair to
say that it is becoming a little bit of a mini epidemic," Berry said.
...Berry suggested that surgeons can avoid these fractures by careful patient
selection, identifying fractures intraoperatively and recommending prophylactic
cerclage for specific patients.'
'"I think there may be a role for us to take a step back from our enthusiasm to
mobilize patients very rapidly and realize that, although we want to mobilize
them rapidly, we could also use a little caution in those first few weeks after
surgery to try to get the best long-term result without a catastrophic early
complication," he said.
For more information
'Berry, DJ. Immediate femoral fracture after primary THA: A mini-epidemic. #15.
Presented at the 24th Annual Current Concepts in Joint Replacement Winter 2007
Meeting. Dec. 12-17, 2007. Orlando, Fla.''
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