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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2015

Resurfacing head size and femoral fracture: Are registry conclusions on head size justified?

Adeel Aqil, Anatole Wiik, Susannah Clarke, Milad Masjedi, Justin Cobb

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Adeel AqilMSK Lab, Imperial College London, Charing Cross Hospital, Fullham Palace Road, London, W6 8RF, UK. a.aqil@imperial.ac.uk.
Anatole WiikMSK Lab, Imperial College London, Charing Cross Hospital, Fullham Palace Road, London, W6 8RF, UK.
Susannah ClarkeMSK Lab, Imperial College London, Charing Cross Hospital, Fullham Palace Road, London, W6 8RF, UK.
Milad MasjediMSK Lab, Imperial College London, Charing Cross Hospital, Fullham Palace Road, London, W6 8RF, UK.
Justin CobbMSK Lab, Imperial College London, Charing Cross Hospital, Fullham Palace Road, London, W6 8RF, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundJoint registries report that peri-prosthetic fractures are the most common reason for early revision of a hip resurfacing arthroplasty (HRA) and are twice as likely with small implant sizes. However, a national survey found peri-prosthetic fracture to be strongly associated with surgical accuracy. We therefore asked whether the force required to induce a peri-prosthetic fracture: (1) was significantly lower when using smaller implants and (2) correlated to the size of implant used, when surgery was performed accurately.

methodsTo ensure an adequate power, we calculated our sample size from pilot data. Forty-four femurs were tested in two experiments. The first experiment tested femurs with either a small (48 mm) or a large (54 mm) HRA implant. The second involved testing femurs with a range of implant sizes. A rapid prototyped femur-specific guide ensured accurate implantation. Specimens were then vertically loaded in a servo-hydraulic testing machine till fracture. Displacement (mm) and force (N) required for fracture were recorded.

resultsA median force of 1081 N was required to fracture specimens implanted with small 48-mm heads, while 1134 N was required when a 54-mm head was used (U = 77, z = -0.054, p = 0.957). Implant head size and force required to fracture were not related, r = 0.12, p = 0.63.

conclusionsThe force required to induce a resurfacing peri-prosthetic fracture was not related to the size of the implant. The increased failure rate seen in all registries is unlikely to be directly the result of this single variable. Correctly performed resurfacing arthroplasty is highly resistant to fracture.

Indexed as

Hip ProsthesisProsthesis FailureAcetabulumBiomechanical PhenomenaFemoral FracturesHumansModels, AnatomicPeriprosthetic FracturesPilot ProjectsProsthesis DesignReoperationFailureFemoral fractureHead sizeResurfacing

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.