Evidence map›Paper›PMID 38548874›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Outcomes of conversion total hip arthroplasty for failed fixation of intertrochanteric fractures with monoblock distal-loading reconstruction stem.

Dhanasekaran Soundarrajan, Helawi Tewabe Fanta, Rithika Singh, Palanisami Dhanasekararaja, Natesan Rajkumar, Shanmuganathan Rajasekaran

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

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5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Dhanasekaran SoundarrajanDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India. soundarortho@gmail.com.ORCID http://orcid.org/0000-0002-2444-1287
Helawi Tewabe FantaDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India.
Rithika SinghDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India.
Palanisami DhanasekararajaDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India.
Natesan RajkumarDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India.
Shanmuganathan RajasekaranDepartment of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India.
Ganga Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of our study was to analyze the clinical and radiological outcomes of conversion total hip arthroplasty (THA) for failed fixation of proximal femur fractures with monoblock grit-blasted titanium reconstruction stem (Wagner self-locking stem, Zimmer). PATIENTS AND

methodsThirty-nine patients were included in this retrospective analysis undergoing conversion THA for failed cephalomedullary nail or dynamic hip screw fixation for intertrochanteric fractures from January 2017 to January 2022. The clinical evaluation was done using Harris hip score. The radiological outcomes measured were subsidence, level of osteointegration, stem-canal fill ratio and heterotopic bone formation. The complications were noted postoperatively and during the follow-up.

resultsThe mean follow-up at the end of the study was 27.8 months (range, 14-72 months). There was a significant improvement in the Harris hip score over serial follow-ups (p < 0.001), but after 2 years, there was no statistically significant difference (p = 0.46). According to Engh's criteria, stable ingrowth was noted in 35 stems, fibrous stable ingrowth was noted in 4 stems and no patients had progressive subsidence and unstable stem. The mean stem-canal fill percentages were 91.8 ± 5.4% at the mid-stem and 80.3 ± 11.5% at the stem tip. Heterotopic ossification Brooker grade 2 was noted in 8 patients, and no patients had grade 3 or 4 heterotopic ossification. There were 7 (17.9%) intraoperative periprosthetic fractures, and greater trochanteric avulsion was noted in 2 patients in the follow-up.

conclusionConversion THA using monoblock tapered distal loading stems bypasses the calcar deficiency and gives stable fixation in failed fixation of intertrochanteric fractures. It gives good radiological outcome and significant improvement in the clinical outcomes compared to the preoperative disability. However, caution should be noted for risk of intraoperative periprosthetic fractures in this subgroup of patients.

Indexed as

Arthroplasty, Replacement, HipHip FracturesHip ProsthesisReoperationAdultAgedAged, 80 and overFemaleFracture Fixation, InternalHumansMaleMiddle AgedPostoperative ComplicationsProsthesis DesignRetrospective StudiesTreatment OutcomeConversion hip arthroplastyDistal loading stemFailed intertrochanteric fracturesProximal femur fractureSalvage hip arthroplastyTotal hip arthroplastyWagner SL

Identifiers

PMID38548874
OpenAlexW4393316419

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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.