Comparison of a Cemented, Polished Tapered Stem and an Anatomic Stem for Femoral Neck Fracture

Postoperative periprosthetic femoral fracture after hip arthroplasty is associated with considerable morbidity and mortality. Recent cohort studies have demonstrated a high incidence of PPF in elderly patients treated with two commonly used polished, tapered, collarless stems in elderly patients. The aim of this study was to compare the rate and characteristics of PPF in a consecutive cohort of patients treated either the polished tapered CTP stem or the matte anatomic SP2 stem in an elderly population above 80 years of age with femoral neck fracture.

Study Overview

• Status: Completed
• Conditions: Hip Fracture; Femoral Neck Fracture; Periprosthetic Femoral Fracture

• Study Type: Observational
• Enrollment (Actual): 1014

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 80 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

We included all patients above the age of 80 years old, operated between September 2009 and April 2015 with a primary hip arthroplasty for an acute displaced femoral neck fractures. Patients were treated either with the cemented CPT or SP2 stems.

Description

Inclusion Criteria:

• Displaced femoral neck fracture
• Treated with a primary hip arthroplasty

Exclusion Criteria:

• Secondary arthroplasty due to sequel after femoral fracture

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
CPT stem; Patients treated with a polished, tapered femoral stem as a hip arthroplasty for a displaced femoral neck fracture
SP2 stem; Patients treated with a anatomic femoral stem as a hip arthroplasty for a displaced femoral neck fracture

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Incidence of periprosthetic femoral fracture	2 years

Secondary Outcome Measures

Outcome Measure	Time Frame
Mortality	2 years
Type of periprosthetic femoral fracture	2 years
Type of complications after surgery for periprosthetic femoral fracture	2 years

Collaborators and Investigators

• Sponsor: Sundsvall Hospital

Publications and helpful links

General Publications

• Inngul C, Enocson A. Postoperative periprosthetic fractures in patients with an Exeter stem due to a femoral neck fracture: cumulative incidence and surgical outcome. Int Orthop. 2015 Sep;39(9):1683-8. doi: 10.1007/s00264-014-2570-0. Epub 2014 Oct 24.
• Broden C, Mukka S, Muren O, Eisler T, Boden H, Stark A, Skoldenberg O. High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem. Acta Orthop. 2015 Apr;86(2):169-74. doi: 10.3109/17453674.2014.971388. Epub 2014 Oct 3.
• Thien TM, Chatziagorou G, Garellick G, Furnes O, Havelin LI, Makela K, Overgaard S, Pedersen A, Eskelinen A, Pulkkinen P, Karrholm J. Periprosthetic femoral fracture within two years after total hip replacement: analysis of 437,629 operations in the nordic arthroplasty register association database. J Bone Joint Surg Am. 2014 Oct 1;96(19):e167. doi: 10.2106/JBJS.M.00643.

Study record dates

Study Major Dates

• Study Start: September 1, 2009
• Primary Completion (Actual): April 1, 2015
• Study Completion (Actual): April 1, 2015

Study Registration Dates

• First Submitted: October 28, 2015
• First Submitted That Met QC Criteria: October 28, 2015
• First Posted (Estimate): October 29, 2015

Study Record Updates

• Last Update Posted (Estimate): May 12, 2016
• Last Update Submitted That Met QC Criteria: May 11, 2016
• Last Verified: May 1, 2016

More Information

Terms related to this study

• Keywords: femoral neck fracture; hip arthroplasty; complication; periprosthetic femoral fracture
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Hip Injuries; Femoral Fractures; Fractures, Bone; Hip Fractures; Femoral Neck Fractures
• Other Study ID Numbers: SM_IV