ArticleOrthopaedic surgery2021
Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients with Hip Dysplasia Undergoing Total Hip Arthroplasty with Uncemented Prostheses.
Article in Orthopaedic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Automated impaction in uncemented total hip arthroplasty : a systematic review and meta-analysis.Bone & joint open · 2026Pooled it
- 'THA for DDH: replacement principles and techniques - femoral side'.EFORT open reviews · 2026Review
- Ipsilateral Knee Pain After Total Hip Arthroplasty: Pathogenesis and Intervention Strategies-A Narrative Review.Journal of pain research · 2026Review
- Factors Associated With Complications in 176 Crowe IV Hips Treated With Total Hip Arthroplasty.Orthopaedic surgery · 2025Article
- Modular Femoral Stem for Hartofilakidis Type C Hip Dysplasia: Is It Necessary for 1-mm Increment of Distal Stem Diameter?Orthopaedic surgery · 2025Article
- Evaluating the impact of Age-Adjusted Charlson Comorbidity Index on in-hospital complications in patients with femoral fracture: a retrospective cohort analysis from the MIMIC-IV 2.2 database.Frontiers in medicine · 2025Article
- Morphological and bone defect mapping analysis of true acetabulum in Crowe type IV hip dysplasia.Journal of orthopaedic surgery and research · 2024Article
- Intraoperative Periprosthetic Fractures in Total Hip Arthroplasty: A 1.6-Million-Patient Analysis of Complications, Costs, and the Challenges in AI-Based Prediction.Journal of clinical medicine · 2024Article
- The Effect of the Morphology of the Femur and Acetabulum in Dysplastic Hips on the Selection of Arthroplasty Femoral Implants: A Computer Tomography-Based Study.Orthopaedic surgery · 2024Article
- Intraoperative Acetabular Fractures in Primary Total Hip Arthroplasty Management and Functional Outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system.BMC musculoskeletal disorders · 2023Article
- Three-dimensional morphological study of the proximal femur in Crowe type IV developmental dysplasia of the hip.Journal of orthopaedic surgery and research · 2021Article
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the potential risk factors for intraoperative periprosthetic femoral fractures in patients with developmental dysplasia of the hip (DDH) undergoing total hip arthroplasty (THA).
methodsThis was a retrospective study. Patients who were diagnosed with DDH and undergoing THA (by artificial joint replacement) at our hospital from January 1999 to December 2019 were included in this study. Clinical and radiological factors were obtained from their medical records, such as age, sex, Crowe classification, morphological features of proximal femur, and features of surgical procedure. The outcome of interest was the occurrence of intraoperative periprosthetic femoral fracture, which was recorded and classified according to the Vancouver classification system. According to the fracture status, the patients were divided into two groups: the fracture group and the non-fracture group. Multivariate logistic regression model was built to identify the risk factors for these fractures.
resultsA total of 1252 hips were finally included. Intraoperative periprosthetic femoral fractures were identified in 62 hips. The incidence of intraoperative periprosthetic femoral fractures in patients with DDH undergoing THA was 4.95%. There were 22 patients (proportion = 35.48%, incidence = 1.76%) with Type A fractures, 38 (proportion = 61.29%, incidence = 3.04%) with Type B fractures, and two (proportion = 3.23%, incidence = 0.16%) with Type C fractures. Six independent risk factors for intraoperative periprosthetic femoral fractures were identified: osteoporosis (OR = 3.434; 95% CI, 1.963-6.007), previous surgical history (OR = 4.797; 95% CI, 2.446-9.410), Dorr Type A canal (OR = 3.025; 95% CI, 1.594-5.738), retained femoral neck length (OR = 1.121; 95% CI, 1.043-1.204), implanted metaphyseal-diaphyseal fixation stems (OR = 3.208; 95% CI, 1.562-6.591), and implanted stem with anteversion design (OR = 2.916; 95% CI, 1.473-5.770).
conclusionsThe overall incidence of intraoperative periprosthetic femoral fractures in patients with DDH undergoing THA was 4.95%, which was at a moderate level compared to patients with other diseases undergoing THA. Six independent risk factors were identified: osteoporosis, previous surgical history, Dorr Type A canal, insufficient neck osteotomy level, implantation of metaphyseal-diaphyseal fixation stem, and implantation of a stem with an anteversion design. Comprehending these risk factors might help surgeons prevent the occurrence of these intraoperative periprosthetic femoral fractures in patients with DDH.
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