• J Arthroplasty · Feb 2020

    High Incidence of Intraoperative Fractures With a Specific Cemented Stem Following Intracapsular Displaced Hip Fracture.

    • Melissa Laflamme, Michèle Angers, Jessica Vachon, Veronica Pomerleau, and Annie Arteau.
    • Department of Orthopaedic Surgery, CHU de Québec - Centre Hospitalier de l'Université Laval (CHUL), Québec City, Québec, Canada.
    • J Arthroplasty. 2020 Feb 1; 35 (2): 485-489.

    BackgroundTo reduce costs of orthopedic implants, the government decided to standardize implants used across different specialties in a group of hospitals located in the same geographic area. The usual cemented stem used in the context of intracapsular displaced geriatric hip fractures was replaced by another stem. Abnormal intraoperative calcar and trochanteric fractures were noted. The purpose of this study is to determine the incidence of intraoperative periprosthetic fractures following an intracapsular displaced hip fracture treated with this specific cemented stem compared to the previous implant.MethodsThis is a retrospective cohort study comparing an historic cohort of hip fractures treated with the OmniFit EON (Stryker, Kalamazoo, MI) cemented stem with a new cohort of patients who received the Corail (DePuy Synthes, Warsaw, IN) cemented stem. Four orthopedic surgeons reviewed operative reports and postoperative radiographs.ResultsThe treatment group included 348 patients who received the Corail stem. The control group included 77 patients. The 2 groups had similar baseline characteristics (P > .05) except for the presence of dementia. Incidence of intraoperative calcar or greater trochanteric fracture was 15.5% for the Corail group and 2.7% for the control group (P < .05). No patient-related factors or surgeon-related factors were related to a higher number of fractures in the treatment group (P > .05).ConclusionThe Corail cemented stem presents an abnormal number of iatrogenic intraoperative fractures following displaced femoral neck fracture in our geriatric population. No external factor seems to explain this high number of fractures. Implant design should be questioned.Level Of EvidenceIII.Copyright © 2019 Elsevier Inc. All rights reserved.

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