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Comparison of the outcome following the fixation of osteotomies or fractures associated with total hip replacement using cables or wires: the results at five years

Authors
Berton, C
Published in Journal of Bone and Joint Surgery. British Volume. 2012, vol. 94, no. 11, p. 1475-81
Abstract There are no recent studies comparing cable with wire for the fixation of osteotomies or fractures in total hip replacement (THR). Our objective was to evaluate the five-year clinical and radiological outcomes and complication rates of the two techniques. We undertook a review including all primary and revision THRs performed in one hospital between 1996 and 2005 using cable or wire fixation. Clinical and radiological evaluation was performed five years post-operatively. Cables were used in 51 THRs and wires in 126, and of these, 36 THRs with cable (71%) and 101 with wire (80%) were evaluated at follow-up. The five-year radiographs available for 33 cable and 91 wire THRs revealed rates of breakage of fixation of 12 of 33 (36%) and 42 of 91 (46%), respectively. With cable there was a significantly higher risk of metal debris (68% vs. 9%; adjusted relative risk (RR) 6.6; 95% confidence interval (CI) 3.0 to 14.1), nonunion (36% vs. 21%; adjusted RR 2.0; 95% CI 1.0 to 3.9) and osteolysis around the material, acetabulum or femur (61% vs 19%; adjusted RR 3.9; 95% CI 2.3 to 6.5). Cable breakage increased the risk of osteolysis to 83%. There was a trend towards foreign-body reaction and increased infection with cables. Clinical results did not differ between the groups. In conclusion, we found a higher incidence of complications and a trend towards increased infection and foreign-body reaction with the use of cables.
Keywords AdultAgedAged, 80 and overArthroplasty, Replacement, Hip/adverse effects/instrumentation/methodsBone Wires/adverse effectsFemaleFemur/radiography/surgeryFractures, Bone/surgeryHumansMaleMiddle AgedOrthopedic Fixation Devices/adverse effectsOsteotomy/adverse effects/instrumentation/methodsPostoperative Complications/epidemiologyProspective StudiesTreatment Outcome
Identifiers
PMID: 23109625
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Research group Chirurgie orthopédique et traumatologique (98)
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BERTON, C et al. Comparison of the outcome following the fixation of osteotomies or fractures associated with total hip replacement using cables or wires: the results at five years. In: Journal of Bone and Joint Surgery. British Volume, 2012, vol. 94, n° 11, p. 1475-81. https://archive-ouverte.unige.ch/unige:27465

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Deposited on : 2013-04-10

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