Evidence map›Paper›PMID 29736726›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2018

High incidence of intraoperative calcar fractures with the cementless CLS Spotorno stem.

Carla Timmer, Davey M J M Gerhardt, Enrico de Visser, Marinus de Kleuver, Job L C van Susante

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Carla TimmerDepartment of Orthopedics, Rijnstate Hospital, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.
Davey M J M GerhardtDepartment of Orthopedics, Rijnstate Hospital, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.
Enrico de VisserDepartment of Orthopedics, Rijnstate Hospital, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.
Marinus de KleuverDepartment of Orthopedics, Radboud University, Nijmegen, The Netherlands.
Job L C van SusanteDepartment of Orthopedics, Rijnstate Hospital, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands. jvansusante@rijnstate.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study reports on the incidence of intraoperative calcar fractures with the cementless Spotorno (CLS) stem, and the potential role of a learning curve and implant positioning is investigated.

methodsAfter introduction of the CLS stem, 800 consecutive cementless total hip arthroplasties (THA) were analyzed. The incidence of calcar fracture in the first 400 THA was compared with the second 400 THA, in order to study a potential learning curve effect. According to the instruction for users, varus positioning of the stem was avoided and a femoral neck osteotomy was aimed relatively close to the lesser trochanter since these are assumed to be correlated with calcar fractures. Implant positioning (neck-shaft angle, femoral offset and osteotomy-lesser trochanter distance) was measured on postoperative pelvic radiographs of all THA with calcar fractures and 100 randomly selected uncomplicated control cases.

resultsSeventeen (2.1%) intraoperative calcar fractures were recorded. The incidence of calcar fracture differed between the first 400 THA (n = 11) and the second 400 THA (n = 6). This difference was not statistically significant (p = 0.220); however, these numbers indicate a trend toward a learning effect. No significant difference in stem positioning nor the height of the femoral neck osteotomy was measured between THA with a calcar fracture (n = 17) and the control cases (n = 100).

conclusionsWe report on a high incidence of intraoperative calcar fractures with the use of a CLS stem. The risk for calcar fractures remains clinically significant even after adequate implant positioning in the hands of experienced hip surgeons. Surgeons should be aware of this implant related phenomenon and be alert on this phenomenon intraoperatively.

Indexed as

Arthroplasty, Replacement, HipFemaleFemoral FracturesFollow-Up StudiesHip JointHip ProsthesisHumansIncidenceIntraoperative ComplicationsMaleMiddle AgedNetherlandsProsthesis DesignRadiographyRetrospective StudiesCalcar fractureCementlessCLSFissureHip geometryTotal hip arthroplasty

Identifiers

PMID29736726

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Registered trials

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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.