Método profiláctico para disminuir el riesgo de fracturas interprotésicas femorales

• Belisario Segura ^[1] ; Pablo Maletti ^[1] ; Martín Aguilera ^[1] ; Marcos Torres ^[1] ; Bruno Schmir ^[1] ; Deoclecio Segura ^[1] ; Raúl Silvano ^[1]
  1. [1] Servicio de Cadera y Rodilla, Otamed, Mendoza, Argentina
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 90, Nº. 5, 2025, págs. 457-463
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2025.90.5.1771
• Títulos paralelos:
  • Prophylactic technique to reduce the risk of interprosthetic femoral fractures
• Enlaces
  • Texto completo  1    2  
• Resumen
  • español

    Introducción: Como consecuencia de la mayor expectativa de vida y la longevidad de los pacientes, han aumentado las artroplastias de rodilla y cadera y, por lo tanto, el número de artroplastias ipsilaterales. Esto determina un mayor riesgo de sufrir una fractura interprotésica. Los objetivos de este estudio fueron evaluar la supervivencia libre de fractura interprotésica femoral en pacientes sometidos a artroplastias ipsilaterales de cadera y rodilla, y con factores de riesgo, y analizar su evolución funcional.

    Materiales y Métodos: Se evaluó a 6 pacientes con artroplastias ipsilaterales de cadera y rodilla. El seguimiento promedio fue de 46.5 meses. Los factores de riesgo de fracturas interprotésicas eran: prótesis con vástagos, edad avanzada, osteoporosis, distancia entre vástagos <8 cm, revisiones y obesidad. Se les realizó una osteosíntesis mínimamente invasiva con placa bloqueada en el momento de colocar la prótesis.

    Resultados: No hubo casos de fracturas interprotésicas, infección, aflojamiento o revisión. No se modificó el protocolo de rehabilitación.

    Conclusiones: Hay pocos artículos sobre fracturas interprotésicas y los resultados son dispares, pero coinciden respecto de los factores de riesgo para que se produzcan. Creemos que la técnica de profilaxis con osteosíntesis supone una baja morbimortalidad en el acto intraoperatorio y logra resultados satisfactorios a corto plazo.

  • English

    Introduction: With increasing life expectancy and patient longevity, the number of hip and knee arthroplasties has risen, leading to more ipsilateral joint replacements and, consequently, a higher risk of interprosthetic femoral fractures (IFF). The objectives of this study were to evaluate fracture-free survival in patients with ipsilateral hip and knee arthroplasties who had risk factors for IFF and to assess their functional outcomes. materials and methods: Six patients with ipsilateral hip and knee arthroplasties were evalu-ated, all operated on by the same surgical team. The mean follow-up was 46.5 months. Risk factors for interprosthetic fractures included stemmed prostheses, advanced age, osteoporosis, distance between stems <8 cm, revision surgery, and obesity. At the time of arthroplasty, minimally invasive osteosynthesis with a locking plate was performed as a prophylactic measure. Results: No cases of interprosthetic fracture, infection, loosening, or revision were observed. The rehabilitation protocol was not modified. Conclusion: Although few studies have addressed interprosthetic fractures, and their results are heterogeneous, they consistently highlight the same risk factors. We believe that prophylactic osteosynthesis entails low intraoperative morbidity and mortality and provides satisfactory short-term outcomes.

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