• Arch Orthop Trauma Surg · Dec 2022

    Review

    Post-operative peri-prosthetic fracture rates following the use of cemented polished taper-slip stems for primary total hip arthroplasty: a systematic review.

    • Kwaku Baryeh and David H Sochart.
    • Education Centre, West Middlesex University Hospital, Twickenham Road, Middlesex, TW7 6AF, UK. Kwaku.baryeh1@nhs.net.
    • Arch Orthop Trauma Surg. 2022 Dec 1; 142 (12): 4075-4085.

    IntroductionPeri-prosthetic fractures (PPFs) are a serious complication of total hip arthroplasty (THA) associated with significant morbidity, mortality and re-operation similar to the rates seen following femoral neck fractures. When exploring the PPF rates around cemented stems, many studies combine the results of composite beam and taper-slip stems despite their different philosophies. This review looks specifically at PPFs with the use of cemented stems of the taper-slip philosophy to evaluate the demographics, PPF rate and fracture patterns in this patient cohort.Materials And MethodsA systematic search of Embase, Medline and CINAHL databases was performed to seek studies involving the use of cemented, polished, taper-slip stems, reporting on a rate of post-operative PPF and not involving patient cohorts that were exclusively hip fracture or revision arthroplasty.Results27 studies reported on 505 PPFs with an average time from primary operation to PPF of 71.2 months (2-301 months). The average age of patients who sustained PPFs was 70.6 years (53.5-82 years) and the majority were female (64.2%). The Vancouver B2 fracture type was most common (39.5%). Open reduction and internal fixation represented the management of choice in 61.2% of PPFs. There was a re-operation rate of 11.4%.ConclusionThis review suggests an association with being older and female, and a greater risk of PPFs secondary to low energy falls in cemented polished taper-slip stems.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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