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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 138 - 138
1 Feb 2004
Ramírez-Barragán A Pérez-Ochagavia F Martín-Rodríguez P Persson I Devesa-Cabo F Hernández-Morales J Juan-Vidal AS Terròn-Chaparro M Domínguez-Hernández J Martín-Gòmez E Ruano-Pérez R García-Talavera JR de Pedro-Moro JA
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Introduction and Objectives: The goal of cementless endoprosthetic hip surgery is to improve bone attachment. The gold standard method for evaluating periprosthetic bone characteristics is densitometry. This study was designed to compare periprosthetic bone mass in 2 groups of patients: less than 3 years and more than 3 years after implantation.

Materials and Methods: A total of 195 type ABG-II total hip prostheses were implanted from November 1997 to March 2003. This implant is a hemispheric cup coated with hydroxyapatite, which can additionally be anchored with screws and a short anatomic stem with metaphyseal fixation. DeLee and Gruen zones were analysed.

Results: During the study period, patients with implants less than 3 years old showed no significant changes in bone mineral density around the stem or the cup. In area 7, a statistically significant reduction was noted after 3 years (0.5218g/cm3, p< 0.001). In Gruen’s zones 3 and 4 a non-significant gain was observed after 3 years (1.1618g/cm3).

Discussion and Conclusions: In cup studies, a statistically insignificant increase in density was observed in zone I after 3 years. Noteworthy findings included a loss of function in DeLee zone III and Gruen zones 1 and 7, which has not yet had clinical consequences (at a maximum 6 year follow-up time).


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 133 - 133
1 Feb 2004
Pérez-Ochagavia F Martín-Rodríguez P Persson I Ramírez-Barragán A Prieto-Prat A Terròn-Chaparro M Domínguez-Hernández J de Pedro-Moro JA
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Introduction and Objectives: Periprosthetic fractures are a common phenomenon in revision surgery and following trauma. Treatment strategies range from replacement with a larger stem, metal plates with Dall-Miles wires, and Partridge straps. Our objective is to evaluate the clinical use of Partridge osteosynthesis in periprosthetic femoral fractures.

Materials and Methods: In a period of 6 years (1997–2003), 45 patients presenting with femoral fractures with a hip prosthesis were treated with the Partridge system using nylon material for cerclage and flexible nylon plates (Stryker-Howmedica). Of these, 20 were localised proximal to the tip of the prosthesis (Whittaker Type I), 12 on the tip (Type II), and 13 distal to the tip of the prosthesis (Type III). The study group consisted of 25 females and 20 males, with a mean age of 79.5 years. Mean time between implantation and fracture was 4.5 years. In 78% of the patients (35 of 45), surgery was performed within 48 hours. Open reduction of the fracture was performed, and 6–8 nylon straps were used in most cases. Partridge plates were used in 5 cases. Mean surgical time was 55 minutes, with a mean blood loss volume of 500 milliliters.

Results: There were minor recovery complications in 8 patients (12.6%). There were no deep wound infections. Of the 45 patients, 60% regained their pre-fracture level of function within 6 months. Mean hospital stay duration was 19 days, and 93% of the fractures consolidated with an exuberant callus within the one-year follow-up period. A higher level of care was required by 25% of patients.

Discussion and Conclusions: This simple method of osteosynthesis is indicated for rapid recovery following stabilisation of a periprosthetic femoral fracture. Even with a mobilised prosthesis, the fracture often consolidates with an abundant callus, and the patient is then able to move.