PMID- 37205653
OWN - NLM
STAT- MEDLINE
DCOM- 20230522
LR  - 20230615
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 5
DP  - 2023
TI  - A lower canal fill rate and unreestablished vertical femoral offset may increase 
      the risk of the postoperative periprosthetic fractures after cementless bipolar 
      hemiarthroplasty for femoral neck fractures in elderly patients.
PG  - e0285789
LID - 10.1371/journal.pone.0285789 [doi]
LID - e0285789
AB  - BACKGROUND: Periprosthetic fractures (PPFs) is one of the major causes of failure 
      of hip arthroplasty with cementless stem; however, studies on the incidence and 
      risk factors of PPFs after cementless hemiarthroplasty for femoral neck fractures 
      (FNFs) are lacking. METHODS: This retrospective study included patients who 
      underwent cementless bipolar hemiarthroplasty for displaced intracapsular FNFs. 
      The demographic data were reviewed, Dorr classification was used to describe 
      morphology of the femur, radiological parameters were measured including 
      stem-shaft angle, canal fill ratio (CFR), canal flare index (CFI), morphologic 
      cortical index (MCI), canal calcar ratio (CCR), and vertical and horizontal 
      femoral offset. RESULTS: The sample comprised 10 men and 46 women (affected hip: 
      left, 38; right, 18). The mean patient age was 82.82+/-10.61 (range, 69-93) years, 
      and the mean hemiarthroplasty to PPFs time was 26.28+/-14.04 (range, 6.54-47.77) 
      months. Seven (12.28%) patients had PPFs. A significant relationship was found 
      between the incidence of PPF and CFR (p = 0.012), patients had a significantly 
      smaller femoral stem CFR (0.76%+/-0.11%) than controls (0.85%+/-0.09%). The PPFs 
      group had a significant shorter and unreestablished vertical femoral offset (p = 
      0.048). CONCLUSIONS: A smaller femoral stem CFR associated with a potentially 
      unacceptably high PPFs risk in uncemented hemiarthroplasty for displaced FNFs may 
      result from mismatched prosthesis and bone dimensions in the elderly population, 
      especially when accompanied by a poorly reestablished vertical femoral offset. 
      With increasing evidence of the benefits of cemented fixation, a cemented stem 
      for the treatment of displaced intracapsular FNFs is recommended for such a 
      elderly frail population.
CI  - Copyright: (c) 2023 Zhou et al. This is an open access article distributed under 
      the terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Zhou, Xiaoxiao
AU  - Zhou X
AUID- ORCID: 0000-0002-6123-9600
AD  - Department of Orthopedics, Shanghai University of Medicine & Health Sciences 
      Affiliated Zhoupu Hospital, Shanghai, China.
FAU - Ji, Houlin
AU  - Ji H
AD  - Jinji Lake Community Health Service Center of Suzhou Industrial Park, 215000, 
      Jiangsu, China.
FAU - Wu, Jiajun
AU  - Wu J
AD  - Department of Orthopedics, Shanghai University of Medicine & Health Sciences 
      Affiliated Zhoupu Hospital, Shanghai, China.
FAU - Chen, Haixiao
AU  - Chen H
AD  - Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to 
      Wenzhou Medical University, Zhejiang, China.
FAU - Yang, Yang
AU  - Yang Y
AD  - Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to 
      Wenzhou Medical University, Zhejiang, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230519
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - Aged
MH  - Child, Preschool
MH  - Child
MH  - *Periprosthetic Fractures/diagnostic imaging/etiology/surgery
MH  - *Hip Prosthesis/adverse effects
MH  - *Hemiarthroplasty/adverse effects/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Reoperation/adverse effects
MH  - *Arthroplasty, Replacement, Hip/adverse effects
MH  - Femur/surgery
MH  - *Femoral Neck Fractures/diagnostic imaging/surgery
PMC - PMC10198562
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/19 19:14
MHDA- 2023/05/22 06:42
PMCR- 2023/05/19
CRDT- 2023/05/19 13:33
PHST- 2023/01/07 00:00 [received]
PHST- 2023/04/28 00:00 [accepted]
PHST- 2023/05/22 06:42 [medline]
PHST- 2023/05/19 19:14 [pubmed]
PHST- 2023/05/19 13:33 [entrez]
PHST- 2023/05/19 00:00 [pmc-release]
AID - PONE-D-22-34027 [pii]
AID - 10.1371/journal.pone.0285789 [doi]
PST - epublish
SO  - PLoS One. 2023 May 19;18(5):e0285789. doi: 10.1371/journal.pone.0285789. 
      eCollection 2023.