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Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty

BACKGROUND: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem. METHODS: Ret...

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Autores principales: Hartford, James M., Graw, Bradley P., Frosch, Dominick L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9018540/
https://www.ncbi.nlm.nih.gov/pubmed/35464339
http://dx.doi.org/10.1016/j.artd.2022.02.030
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author Hartford, James M.
Graw, Bradley P.
Frosch, Dominick L.
author_facet Hartford, James M.
Graw, Bradley P.
Frosch, Dominick L.
author_sort Hartford, James M.
collection PubMed
description BACKGROUND: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem. METHODS: Retrospective study of 798 primary total hip replacements by 1 surgeon performed using noncollared dual tapered femoral stems, including 457 implanted using hybrid rasp-impaction broaching and 341 implanted using impaction broaching. Intraoperative and 90-day postoperative fractures were identified in each group. Bivariate tests and multivariate regression analysis were used to compare the 2 groups. RESULTS: There were 33 (4.1%) fractures in the sample, 13 (2.8%) with hybrid rasp-impaction broaching and 20 (5.8%) with impaction broaching (P = .034). Three (0.7%) intraoperative fractures occurred with hybrid rasp-impaction broaching and 12 (3.5%) with impaction broaching (P = .003). Five (1.1%) total calcar fractures occurred with hybrid rasp-impaction broaching and 11 (3.2%) with impaction broaching (P = .034). Intraoperative calcar fractures occurred with 1 (0.2%) hybrid rasp-impaction broaching and 6 (1.8%) impaction broaching (P = .021). In multivariate analyses, hybrid rasp-impaction broaching had a statistically lower odds ratio (OR) for total fracture (OR 0.45 [0.22 to 0.93]); total intraoperative fracture (OR 0.17 [0.05 to 0.60]); total calcar fracture (OR 0.33 [0.11 to 0.97]); intraoperative calcar fracture (OR 0.11 [0.01 to 0.98]); and rate of readmission (OR 0.27 [0.10 to 0.78]). CONCLUSION: The use of a hybrid rasp-impaction broach compared with impaction broach led to a reduced incidence of periprosthetic fractures when using a dual tapered stem through the direct anterior approach.
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spelling pubmed-90185402022-04-21 Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty Hartford, James M. Graw, Bradley P. Frosch, Dominick L. Arthroplast Today Original Research BACKGROUND: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem. METHODS: Retrospective study of 798 primary total hip replacements by 1 surgeon performed using noncollared dual tapered femoral stems, including 457 implanted using hybrid rasp-impaction broaching and 341 implanted using impaction broaching. Intraoperative and 90-day postoperative fractures were identified in each group. Bivariate tests and multivariate regression analysis were used to compare the 2 groups. RESULTS: There were 33 (4.1%) fractures in the sample, 13 (2.8%) with hybrid rasp-impaction broaching and 20 (5.8%) with impaction broaching (P = .034). Three (0.7%) intraoperative fractures occurred with hybrid rasp-impaction broaching and 12 (3.5%) with impaction broaching (P = .003). Five (1.1%) total calcar fractures occurred with hybrid rasp-impaction broaching and 11 (3.2%) with impaction broaching (P = .034). Intraoperative calcar fractures occurred with 1 (0.2%) hybrid rasp-impaction broaching and 6 (1.8%) impaction broaching (P = .021). In multivariate analyses, hybrid rasp-impaction broaching had a statistically lower odds ratio (OR) for total fracture (OR 0.45 [0.22 to 0.93]); total intraoperative fracture (OR 0.17 [0.05 to 0.60]); total calcar fracture (OR 0.33 [0.11 to 0.97]); intraoperative calcar fracture (OR 0.11 [0.01 to 0.98]); and rate of readmission (OR 0.27 [0.10 to 0.78]). CONCLUSION: The use of a hybrid rasp-impaction broach compared with impaction broach led to a reduced incidence of periprosthetic fractures when using a dual tapered stem through the direct anterior approach. Elsevier 2022-04-12 /pmc/articles/PMC9018540/ /pubmed/35464339 http://dx.doi.org/10.1016/j.artd.2022.02.030 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Hartford, James M.
Graw, Bradley P.
Frosch, Dominick L.
Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title_full Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title_fullStr Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title_full_unstemmed Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title_short Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty
title_sort reduced incidence of perioperative periprosthetic fractures using hybrid rasp-impaction broaching over impaction broaching when using the direct anterior approach for total hip arthroplasty
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9018540/
https://www.ncbi.nlm.nih.gov/pubmed/35464339
http://dx.doi.org/10.1016/j.artd.2022.02.030
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