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- Talk
- 07/09/2020
- UK
Calcar Collar Separation at Implantation Increases Odds of Failure of Collar-Calcar Contact during Simulated Periprosthetic Fractures in a Composite Femur Model
Description
In this presentation, Josh Lamb from the University of Leeds discusses the implications of periprosthetic fractures of the femur, particularly following total hip replacement surgeries that utilize cementless stems. He clarifies the understanding that periprosthetic fractures are more likely to occur immediately after surgery and are linked to increased rates of mortality and reoperations, although they remain relatively uncommon. New research highlights that using a collared stem as opposed to a collarless cementless stem can significantly lower the incidence of these fractures due to a better prevention of movement between the stem and femur.
Lamb delves into an experimental setup in which they simulated calcar collar gaps in femurs by varying resection amounts and measuring the impact of these gaps on the likelihood of achieving successful contact between the calcar collar and femur prior to fracture. Their findings indicate that maintaining a gap of 1 millimeter or less maximizes the odds of achieving successful contact, correlating to a 95% likelihood of successful collar function in the event of injury.
The presentation addresses the technical aspects of their methodology, the significance of their findings, and considerations for surgical practices that aim to mitigate fracture risks. Chris Bretherton, the discussant, adds further inquiries about the clinical implications of leaving intentional gaps during implant procedures, leading to a conversation about the relationship between collar contact and load-bearing capacities, reinforcing the importance of precise surgical techniques.