Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: A retrospective review of 198 hips with previous intertrochanteric femur fractures [post]

Weiguang Yu, Xiulan Han, Wenli Chen, Mao Shuai, Mingdong Zhao, Chao Xin Zhang, Guowei Han, Junxing Ye, Meiji Chen, Jintao Zhuang
2020 unpublished
Background: At present, it is unclear which device (uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs).Methods: Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA
more » ... nversion to a UTA or CTA device following failed PFNAs during 2007-2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate.Results: The median follow-up was 65 months (60-69 months). Significant distinctions were observed (87.26±16.62 for UTA vs. 89.32±16.08 for CTA, p=0.021; 86.61±12.24 for symptomatic UTA vs. 88.68±13.30 for symptomatic CTA, p=0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p=0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively).Conclusion: For elderly individuals with IFFs who suffered a failed PFNA, CTA devices seem to have a noteworthy advantage in regard to functional scores and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.
doi:10.21203/rs.2.20877/v2 fatcat:6gqr6jsbene45lo6bujg2svz4q