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Purpose <p>Intraoperative calcar fracture (IOCF) can compromise initial stability, leading to stem subsidence and instability. We aimed to compare 2-year complications and revision rates between patients who sustained IOCF and matched controls without IOCF using short stem total hip arthroplasty (THA).</p> Method <p>Patients who underwent short stem THA from November 2010 to October 2023 were included. They were categorized into those who sustained IOCF and were treated intraoperatively with double-loops cerclage wiring, and those without IOCF. Propensity score matching was performed to balance baseline characteristics between the two groups. The following outcomes were evaluated at two&#xa0;years: femoral stem subsidence, periprosthetic femoral fracture (PFF), periprosthetic joint infection (PJI), dislocation, aseptic femoral loosening, and revision.</p> Results <p>Initially, 844 cases were identified. After matching, 80 and 640 cases were included in IOCF and non-IOCF groups respectively. There was one case (1.25%) of stem subsidence in the IOCF group and 11 cases (1.72%) in the non-IOCF group, with no significant difference (<i>p</i> = 0.76). PFF occurred in one case (1.25%) of the IOCF group and four&#xa0;cases (0.63%) of the non-IOCF group; the difference was not significant (<i>p</i> = 0.53). In the non-IOCF group, there were five cases (0.78%) of PJI, 11 cases (1.72%) of dislocation, one&#xa0;case (0.16%) of aseptic femoral loosening and 13 cases (2%) of revisions. There was no revision in the IOCF group.</p> Conclusion <p>Short stem THA complicated by IOCF, when promptly recognized and treated intraoperatively, did not increase complications or revision rates at two&#xa0;years.</p>

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Do intraoperative calcar fractures increase early complications or revisions in short stem total hip arthroplasty? A propensity score matching study

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Yingyong Suksathien,
  • Jithayut Suarjui,
  • Thanut Tippimanchai,
  • Supakit Asawasudsakorn,
  • Rachawan Suksathien,
  • Pattawat Chuvanichanon

摘要

Purpose

Intraoperative calcar fracture (IOCF) can compromise initial stability, leading to stem subsidence and instability. We aimed to compare 2-year complications and revision rates between patients who sustained IOCF and matched controls without IOCF using short stem total hip arthroplasty (THA).

Method

Patients who underwent short stem THA from November 2010 to October 2023 were included. They were categorized into those who sustained IOCF and were treated intraoperatively with double-loops cerclage wiring, and those without IOCF. Propensity score matching was performed to balance baseline characteristics between the two groups. The following outcomes were evaluated at two years: femoral stem subsidence, periprosthetic femoral fracture (PFF), periprosthetic joint infection (PJI), dislocation, aseptic femoral loosening, and revision.

Results

Initially, 844 cases were identified. After matching, 80 and 640 cases were included in IOCF and non-IOCF groups respectively. There was one case (1.25%) of stem subsidence in the IOCF group and 11 cases (1.72%) in the non-IOCF group, with no significant difference (p = 0.76). PFF occurred in one case (1.25%) of the IOCF group and four cases (0.63%) of the non-IOCF group; the difference was not significant (p = 0.53). In the non-IOCF group, there were five cases (0.78%) of PJI, 11 cases (1.72%) of dislocation, one case (0.16%) of aseptic femoral loosening and 13 cases (2%) of revisions. There was no revision in the IOCF group.

Conclusion

Short stem THA complicated by IOCF, when promptly recognized and treated intraoperatively, did not increase complications or revision rates at two years.