Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures

Objectives:A failed intertrochanteric fixation often leads to functional disability and pain. The most commonly observed complication is “cut-out”, which frequently requires hip arthroplasty in the subsequent period. In this study, we aimed to compare the results of total hip arthroplasty (THA) and...

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Main Authors: Abdullah Merter, Kerem Başarır, Hakan Kocaoğlu, Mustafa Onur Karaca, Emre Anıl Özbek, Mahmut Kalem
Format: Article
Language:English
Published: Galenos Publishing House 2021-04-01
Series:Ankara Üniversitesi Tıp Fakültesi Mecmuas
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Online Access: http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/conversion-to-hip-arthroplasty-after-cut-out-compl/47316
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author Abdullah Merter
Kerem Başarır
Hakan Kocaoğlu
Mustafa Onur Karaca
Emre Anıl Özbek
Mahmut Kalem
author_facet Abdullah Merter
Kerem Başarır
Hakan Kocaoğlu
Mustafa Onur Karaca
Emre Anıl Özbek
Mahmut Kalem
author_sort Abdullah Merter
collection DOAJ
description Objectives:A failed intertrochanteric fixation often leads to functional disability and pain. The most commonly observed complication is “cut-out”, which frequently requires hip arthroplasty in the subsequent period. In this study, we aimed to compare the results of total hip arthroplasty (THA) and hemiarthroplasty (HA) after cut-out complication of proximal femoral nailing (PFN).Materials and Methods:Forty patients who were treated with THA (20 patients) and HA (20 patients) due to cut-out complication following PFN were included in our retrospective study. Age, gender, classification of the pertrochanteric fracture (AO/OTA classification), time to arthroplasty surgery, operative time, total blood loss, and complications were reviewed. The clinical results were evaluated by the ambulatory status, Harris hip score (HHS) and visual analog scale (VAS) score at the second year follow-up.Results:The amount of blood loss and the operative time were significantly higher in the THA group (p=0.001). Post-operative second year VAS score and HHS were similar in both groups (p=0.989 and p=0.820, respectively). There was no significant difference between the two groups in terms of complications rate (p=0.294).Conclusion:Converting to hip arthroplasty is a successful choice in the treatment of cut-out complications following PFN. Both THA and HA groups had similar clinical results, with the HA group being more advantageous regarding cost, operative time, amount of blood loss, and rate of infection. However, the only valid option for those with acetabular defects during cut-out is THA.
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spelling doaj-art-8d62da1ee71e4bc69733d78a54099baf2025-08-20T03:37:56ZengGalenos Publishing HouseAnkara Üniversitesi Tıp Fakültesi Mecmuas1307-56081307-56082021-04-0174111211710.4274/atfm.galenos.2020.0932613049054Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric FracturesAbdullah Merter0Kerem Başarır1Hakan Kocaoğlu2Mustafa Onur Karaca3Emre Anıl Özbek4Mahmut Kalem5 Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara, Turkey Objectives:A failed intertrochanteric fixation often leads to functional disability and pain. The most commonly observed complication is “cut-out”, which frequently requires hip arthroplasty in the subsequent period. In this study, we aimed to compare the results of total hip arthroplasty (THA) and hemiarthroplasty (HA) after cut-out complication of proximal femoral nailing (PFN).Materials and Methods:Forty patients who were treated with THA (20 patients) and HA (20 patients) due to cut-out complication following PFN were included in our retrospective study. Age, gender, classification of the pertrochanteric fracture (AO/OTA classification), time to arthroplasty surgery, operative time, total blood loss, and complications were reviewed. The clinical results were evaluated by the ambulatory status, Harris hip score (HHS) and visual analog scale (VAS) score at the second year follow-up.Results:The amount of blood loss and the operative time were significantly higher in the THA group (p=0.001). Post-operative second year VAS score and HHS were similar in both groups (p=0.989 and p=0.820, respectively). There was no significant difference between the two groups in terms of complications rate (p=0.294).Conclusion:Converting to hip arthroplasty is a successful choice in the treatment of cut-out complications following PFN. Both THA and HA groups had similar clinical results, with the HA group being more advantageous regarding cost, operative time, amount of blood loss, and rate of infection. However, the only valid option for those with acetabular defects during cut-out is THA. http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/conversion-to-hip-arthroplasty-after-cut-out-compl/47316 cut-outpertrochanteric fractureintertrochanteric fractureproximal femoral nailingintramedullary nailinghip arthroplasty
spellingShingle Abdullah Merter
Kerem Başarır
Hakan Kocaoğlu
Mustafa Onur Karaca
Emre Anıl Özbek
Mahmut Kalem
Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
Ankara Üniversitesi Tıp Fakültesi Mecmuas
cut-out
pertrochanteric fracture
intertrochanteric fracture
proximal femoral nailing
intramedullary nailing
hip arthroplasty
title Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
title_full Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
title_fullStr Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
title_full_unstemmed Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
title_short Conversion to Hip Arthroplasty After Cut-out Complication of Proximal Femoral Nailing (PFN) in Pertrochanteric Fractures
title_sort conversion to hip arthroplasty after cut out complication of proximal femoral nailing pfn in pertrochanteric fractures
topic cut-out
pertrochanteric fracture
intertrochanteric fracture
proximal femoral nailing
intramedullary nailing
hip arthroplasty
url http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/conversion-to-hip-arthroplasty-after-cut-out-compl/47316
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