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January 29, 2025Journal of Orthopaedic Surgery and ResearchOpen Access

Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?

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Authors

MLMatthias LugerJohannes Kepler University of LinzSFSandra FeldlerJohannes Kepler University of LinzMGManuel GahleitnerJohannes Kepler University of Linz

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Implication

Retrospective comparative study reveals distinct fracture patterns between short and straight stem hip arthroplasty despite largely similar anatomy, indicating implant design influences injury type.

Key Points

  • To compare femoral and pelvic morphological parameters in patients who experienced early periprosthetic femoral fractures following either short stem or straight stem cementless total hip arthroplasty.
  • Retrospective propensity-score matched study screened an institutional database of 5,358 total hip arthroplasties for early fractures within 90 days of surgery.
  • A total of 136 primary cementless fracture cases were evaluated, yielding a matched cohort of 67 straight stem and 37 short stem cases.
  • Radiological parameters characterizing proximal femoral and pelvic geometry, along with Vancouver fracture classifications, were compared between groups.
  • Distance from the anterior superior iliac spine to the greater trochanter was significantly lower in the straight stem group compared to the short stem group (96.4 mm vs. 104.8 mm, p = 0.024).
  • All other measured femoral and pelvic parameters showed no statistically significant differences between the two stem groups.
  • Vancouver type A fractures were significantly more frequent in straight stem implants, whereas Vancouver type B fractures occurred significantly more often in short stem implants.

Cite This Study

Luger et al. (2025) studied this question.

synapsesocial.com/papers/6a7ca5df0dd979f2a48ce1bchttps://doi.org/10.1186/s13018-025-05502-y
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intraoperative Periprosthetic Fractures During Total Hip Arthroplasty2008 · 223 citations
  2. 2Translateral Surgical Approach to the Hip1993 · 49 citations
  3. 3Periprosthetic femoral fractures and trying to avoid them2017 · 202 citations