Surgeon-Stratified Periprosthetic Fracture Risk in a Single-Hospital Cohort of 1531 Uncemented ABG-II Femoral Stems at Primary Total Hip Arthroplasty.

Purpose: Late periprosthetic fracture risk with uncemented ABG-II femoral stems at primary total hip arthroplasty (THA) has been reported before, but single-hospital surgeon-stratified reports of this implant have never been published. We asked whether periprosthetic fracture rates of ABG-II femoral stems implanted at a single tertiary hospital depended on patients' age, gender and the operating surgeon. Methods: The study included 1531 consecutive primary ABG-II femoral stems implanted at a single tertiary hospital between January 1, 2012 and December 31, 2018. The Kaplan-Meier and Cox regression analyses were performed after 3.6-10.6 years of follow-up. Results: In the cohort, we recorded 8 intraoperative, 22 early postoperative (within 90 days of implantation) and 26 late periprosthetic fractures (over 90 days postoperatively). The revision rate of ABG-II femoral stems was 5.1/100 component-years for early and 0.3/100 component-years for late periprosthetic fractures. The Kaplan-Meier cumulative probability of periprosthetic fracture was 2.1% at one, 2.3% at 2, 3.2% at 5, and 6.5% at 10 years after the implantation. Higher patient's age at operation was an independent risk factor of subsequent periprosthetic fracture (hazard ratio 1.07, 95% confidence interval 1.03-1.10; p < 0.01), regardless of the operating surgeon. Most of the fractured femora were Dorr type C (stovepipe). Conclusion: The study presents the largest published ABG-II femoral stem cohort from a single hospital so far with 9291 component-years of observation. Periprosthetic fracture risk of ABG-II increased with patients' age, had no variability between different surgeons, and was considerably higher from other uncemented femoral stems used at the same hospital. Level of Evidence: III.

Cohort analysis of two thousand nine hundred forty-three Link Lubinus SP II cemented total hip arthroplasties from a single hospital with surgeon stratification and twenty six thousand, nine hundred and eighty one component-years of follow-up.

PURPOSE: Cemented total hip endoprosthesis Link Lubinus SP II has been used for decades with very good results in arthroplasty registries, but surgeon-stratified reports of endoprosthetic survival are very rare. The aim of the presented single hospital cohort analysis of this implant was to determine Link Lubinus SP II survival rates 10/15/20/25/30 years after the primary implantation and to find out whether endoprosthesis survival depended on patients' age, gender, operated side, implanted femoral head diameter, and the operating surgeon. METHODS: The study included 2943 consecutive primary Link Lubinus SP II hip endoprostheses implanted at the University Medical Centre Ljubljana, Department of Orthopaedic Surgery (Ljubljana, Slovenia) between January 1, 1985, and December 31, 2018. Kaplan-Meier analysis and Cox regression were performed after minimum two and maximum 30 years of follow-up. RESULTS: At 10/15/20/25/30 years after implantation, the estimated cumulative proportion of revision-free surviving Link Lubinus SP II total hip endoprostheses was 94/90/88/87/87% and the cumulative proportion with unremoved endoprosthetic components was 96/93/90/89/89%, respectively. Higher patient's age at operation was associated with lower risk of subsequent implant removal (hazard ratio 0.97 for each additional year of age; 95% confidence interval 0.95-0.99; p = 0.00), while the patient's gender, the implanted femoral head diameter, and the operating surgeon had no significant impact on implant survival. CONCLUSION: The study presents the largest published Link Lubinus SP II total hip arthroplasty cohort from a single non-developmental hospital with 26,981 component-years of observation. The findings highlight excellent outcomes of this implant in the elderly population, regardless of performance variability between surgeons.

Giant Cell Tumor of Bone Versus Tenosynovial Giant Cell Tumor - Similarities and Differences.

Giant cell tumor of bone (GCTB) and tenosynovial giant cell tumor (TGCT) share misleadingly similar names, soft texture and brown color macroscopically, osteoclast-like multinucleated giant cells microscopically and localisation in the musculoskeletal system. However, these two tumor types are biologically and clinically two distinct entities with different natural courses of progression and considerably different modes of surgical and medical treatment. In this article, we provide a detailed update on the similarities and the differences between both tumor types.GCTB is a locally aggressive osteolytic bone tumor, commonly seen in patients in their third decade of life. It usually occurs as a solitary lesion in the meta-epiphyseal region of long bones. It can be diagnosed using plain radiographic imaging, CT radiography or MRI to estimate the tumor extent, soft tissue and joint involvement. GCTB is usually treated with intralesional excision by curettage. Systemically, it can be treated with bisphosphonates and denosumab or radiotherapy.TGCT is a rare, slowly progressing tumor of synovial tissue, affecting the joint, tendon sheath or bursa, mostly seen in middle-aged patients. TGCT is usually not visible on radiographs and MRI is mostly used to enable assessment of potential bone involvement and distinguishing between two TGCT types. Localised TGCT is mostly treated with marginal surgical resection, while diffuse TGCT is optimally treated with total synovectomy and is more difficult to remove. Additionally, radiotherapy, intraarticular injection of radioactive isotopes, anti-TNF-α antibodies and targeted medications may be used.