Evidence map›Paper›PMID 40399726›Full record

ArticleArchives of orthopaedic and trauma surgery2025

Femoral stem subsidence after uncemented total or hemiarthroplasty for femoral neck fractures does not correlate with local femoral bone quality evaluated by Dorr and cortical thickness index.

Rahel Badoux, Manuel Waltenspül, Michael Dietrich, Method Kabelitz

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Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Rahel BadouxDepartment of Orthopaedics, Hand- and Trauma Surgery, Stadtspital Zürich, Zürich, Switzerland.
Manuel WaltenspülDepartment of Orthopaedics, Hand- and Trauma Surgery, Stadtspital Zürich, Zürich, Switzerland.
Michael DietrichDepartment of Orthopaedics, Hand- and Trauma Surgery, Stadtspital Zürich, Zürich, Switzerland.
Method KabelitzDepartment of Orthopaedics, Hand- and Trauma Surgery, Stadtspital Zürich, Zürich, Switzerland. kabelitz.method@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe increase in femoral neck fractures in elderly individuals is primarily attributable to reduced bone mineral density (BMD). Dual-energy X-ray absorptiometry (DEXA), has been demonstrated to be a reliable bone mineral density (BMD) estimate. Femoral cortical thickness index (CTI), and Dorr classification are reliable assessment methods of the femoral cortical thickness. Patients with low BMD, low CTI or Dorr C who undergo uncemented total hip arthroplasty (THA) or hemiarthroplasty (HA) are at an increased risk of early femoral stem subsidence (FSS). Dual-energy X-ray absorptiometry (DEXA), femoral cortical thickness index (CTI), and Dorr classification have been demonstrated to be reliable bone mineral density (BMD) estimates. Patients with low BMD who undergo uncemented total hip arthroplasty (THA) or hemiarthroplasty (HA) are at an increased risk of early femoral stem subsidence (FSS). The objective of this study was to investigate the relationship between CTI, Dorr classification, and early FSS, hypothesizing that these indicators can predict stem subsidence. MATERIAL AND

methodsA retrospective analysis was conducted on patients with femoral neck fractures treated by uncemented THA or HA using the direct anterior approach (DAA). Preoperative radiographs were utilized to assess CTI and Dorr classification. Postoperative FSS was the primary outcome measure, with follow-up X-rays averaging 403 days (range 38-3371). The canal fill ratio (CFR) was observed at four levels postoperatively. A subsequent statistical analysis was conducted to examine the correlation between CTI, Dorr classification, CFR, BMI, age, and FSS.

resultsThe study's sample population included 64 patients (20 male, 44 female) with a mean age of 73 ± 9 years, who were treated between June 2020 and February 2024. The mean femoral CTI was 0.51 ± 0.08 on the fractured side and 0.54 ± 0.06 on the contralateral unaffected side. The mean FSS was 1.02 ± 1.49 mm. A subsidence of at least 5 mm was identified in a mere two patients, both of whom were classified as Dorr B. A modest correlation (r = 0.27) was noted between FSS and CRF 2.

conclusionNeither decreased BMD nor cortical thickness correlated with femoral stem subsidence. LEVEL OF EVIDENCE: Level III, Therapeutic study.

Indexed as

Arthroplasty, Replacement, HipFemoral Neck FracturesFemurHemiarthroplastyHip ProsthesisProsthesis FailureAbsorptiometry, PhotonAgedAged, 80 and overBone DensityFemaleHumansMaleMiddle AgedRetrospective StudiesCortical thickness indexFemoral neck fractureGeriatricOsteoporosisStem subsidence

Identifiers

PMID40399726

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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.