{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T07:17:46Z","timestamp":1760426266433,"version":"3.37.3"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The pelvic and femoral morphology are associated with the occurrence of early periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA). Differences exist depending on the performed approach and implanted stem design. Therefore, this study was conducted to analyze the pelvic and femoral morphology in cementless short stem THA via a minimally-invasive (MIS) anterolateral approach.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective, single-center, multi-surgeon, comparative propensity-score matched study of a cohort of 1826 short stem THAs was conducted. A total of 39 PFFs within the first 90\u00a0days after surgery was matched on a 2:1 ratio to non-fracture patients. The morphology of the proximal femur was analyzed with canal flare index (CFI), canal-calcar ratio (CCR), canal-bone ratio (CBR), morphological cortical index (MCI), and femoral cortical index (CI). The pelvic morphology was analyzed with ilium\u2013ischial ratio (IR), distance anterior superior iliac spine to the tip of the greater trochanter (AGT). Both groups were analyzed regarding several parameters for femoral and pelvic morphology in non-parametric testing and univariate regression analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A significantly higher AGT was detected in the fracture group (104.5\u00a0mm\u2009\u00b1\u200918 versus 97.4\u00a0mm\u2009\u00b1\u20099.8; <jats:italic>p<\/jats:italic>\u2009=\u20090.016). All other femoral and pelvic parameters did not differ between both groups, also when compared depending on the Vancouver type of the PFF.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The morphology of the proximal femur and the pelvis do not differ in several radiological parameters in patients sustaining a PFF in cementless short stem THA via an anterolateral approach compared with matched non-fracture group. The findings are controversial to other studies with different stem types and approaches. Future studies should focus on analyzing the influence of the pelvic geometry and the shape of the proximal femur in the occurrence of PFFs in different approaches with the same stem type and vice versa.<\/jats:p>\n                <jats:p><jats:italic>Level of Evidence<\/jats:italic> Level III case-controlled study<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s10195-024-00795-x","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T15:02:42Z","timestamp":1730732562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is there a difference in pelvic and femoral morphology in early periprosthetic femoral fracture in cementless short stem total hip arthroplasty via an anterolateral approach?"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4708-5254","authenticated-orcid":false,"given":"Matthias","family":"Luger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Feldler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Schopper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Gotterbarm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"issue":"1 Supple A","key":"795_CR1","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0220.R1","volume":"99-B","author":"AV Carli","year":"2017","unstructured":"Carli AV, Negus JJ, Haddad FS (2017) Periprosthetic femoral fractures and trying to avoid them: what is the contribution of femoral component design to the increased risk of periprosthetic femoral fracture? Bone Joint J 99-B(1 Supple A):50\u201359. https:\/\/doi.org\/10.1302\/0301-620X.99B1.BJJ-2016-0220.R1","journal-title":"Bone Joint J"},{"issue":"2","key":"795_CR2","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.arth.2017.09.015","volume":"33","author":"M Dietrich","year":"2018","unstructured":"Dietrich M, Kabelitz M, Dora C, Zingg PO (2018) Perioperative fractures in cementless total hip arthroplasty using the direct anterior minimally invasive approach: reduced risk with short stems. J Arthroplasty 33(2):548\u2013554. https:\/\/doi.org\/10.1016\/j.arth.2017.09.015","journal-title":"J Arthroplasty"},{"issue":"4","key":"795_CR3","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1016\/j.arth.2022.10.027","volume":"38","author":"M Luger","year":"2023","unstructured":"Luger M, Feldler S, Pisecky L, Klasan A, Gotterbarm T, Schopper C (2023) Periprosthetic femoral fractures in cementless short versus straight stem total hip arthroplasty: a propensity score matched analysis. J Arthroplasty 38(4):751\u2013756. https:\/\/doi.org\/10.1016\/j.arth.2022.10.027","journal-title":"J Arthroplasty"},{"issue":"3","key":"795_CR4","first-page":"190","volume":"98","author":"CC Wu","year":"1999","unstructured":"Wu CC, Au MK, Wu SS, Lin LC (1999) Risk factors for postoperative femoral fracture in cementless hip arthroplasty. J Formos Med Assoc 98(3):190\u2013194","journal-title":"J Formos Med Assoc"},{"issue":"3","key":"795_CR5","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1302\/0301-620X.98B3.36515","volume":"98-B","author":"C Rogmark","year":"2016","unstructured":"Rogmark C, Leonardsson O (2016) Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients. Bone Joint J 98-B(3):291\u2013297. https:\/\/doi.org\/10.1302\/0301-620X.98B3.36515","journal-title":"Bone Joint J"},{"issue":"6","key":"795_CR6","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1302\/0301-620X.97B6.35022","volume":"97B","author":"MP Bonnin","year":"2015","unstructured":"Bonnin MP, Neto CC, Aitsiselmi T, Murphy CG, Bossard N, Roche S (2015) Increased incidence of femoral fractures in small femurs and women undergoing uncemented total hip arthroplasty\u2014why? Bone Joint J 97B(6):741\u2013748. https:\/\/doi.org\/10.1302\/0301-620X.97B6.35022","journal-title":"Bone Joint J"},{"issue":"2","key":"795_CR7","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1007\/s11999-013-3231-0","volume":"472","author":"JA Rodriguez","year":"2014","unstructured":"Rodriguez JA, Deshmukh AJ, Rathod PA, Greiz ML, Deshmane PP, Hepinstall MS, Ranawat AS (2014) Does the direct anterior approach in THA offer faster rehabilitation and comparable safety to the posterior approach? Clin Orthop Relat Res 472(2):455\u2013463. https:\/\/doi.org\/10.1007\/s11999-013-3231-0","journal-title":"Clin Orthop Relat Res"},{"key":"795_CR8","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/01.blo.0000238859.46615.34","volume":"453","author":"RM Meneghini","year":"2006","unstructured":"Meneghini RM, Pagnano MW, Trousdale RT, Hozack WJ (2006) Muscle damage during MIS total hip arthroplasty: smith-petersen versus posterior approach. Clin Orthop Relat Res 453:293\u2013298. https:\/\/doi.org\/10.1097\/01.blo.0000238859.46615.34","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"795_CR9","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1007\/s11999.0000000000000112","volume":"476","author":"MJ Taunton","year":"2018","unstructured":"Taunton MJ, Trousdale RT, Sierra RJ, Kaufman K, Pagnano MW (2018) John charnley award: randomized clinical trial of direct anterior and miniposterior approach THA: which provides better functional recovery? Clin Orthop Relat Res 476(2):216\u2013229. https:\/\/doi.org\/10.1007\/s11999.0000000000000112","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"795_CR10","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1016\/j.arth.2016.03.007","volume":"31","author":"KR Berend","year":"2016","unstructured":"Berend KR, Mirza AJ, Morris MJ, Lombardi AV Jr (2016) Risk of periprosthetic fractures with direct anterior primary total hip arthroplasty. J Arthroplasty 31(10):2295\u20132298. https:\/\/doi.org\/10.1016\/j.arth.2016.03.007","journal-title":"J Arthroplasty"},{"issue":"8S","key":"795_CR11","doi-asserted-by":"publisher","first-page":"S901","DOI":"10.1016\/j.arth.2022.03.054","volume":"37","author":"NP McGoldrick","year":"2022","unstructured":"McGoldrick NP, Cochran MJ, Biniam B, Bhullar RS, Beaule PE, Kim PR, Gofton WT, Grammatopoulos G (2022) Can we predict fracture when using a short cementless femoral stem in the anterior approach? J Arthroplasty 37(8S):S901\u2013S907. https:\/\/doi.org\/10.1016\/j.arth.2022.03.054","journal-title":"J Arthroplasty"},{"issue":"2","key":"795_CR12","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s11999-011-2068-7","volume":"470","author":"RG Molli","year":"2012","unstructured":"Molli RG, Lombardi AV Jr, Berend KR, Adams JB, Sneller MA (2012) A short tapered stem reduces intraoperative complications in primary total hip arthroplasty. Clin Orthop Relat Res 470(2):450\u2013461. https:\/\/doi.org\/10.1007\/s11999-011-2068-7","journal-title":"Clin Orthop Relat Res"},{"issue":"6S","key":"795_CR13","doi-asserted-by":"publisher","first-page":"S359","DOI":"10.1016\/j.arth.2020.02.048","volume":"35","author":"KC Bigart","year":"2020","unstructured":"Bigart KC, Nahhas CR, Ruzich GP, Culvern CN, Salzano MB, Della Valle CJ, Nam D (2020) Does femoral morphology predict the risk of periprosthetic fracture after cementless total hip arthroplasty? J Arthroplasty 35(6S):S359\u2013S363. https:\/\/doi.org\/10.1016\/j.arth.2020.02.048","journal-title":"J Arthroplasty"},{"issue":"5","key":"795_CR14","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1016\/j.arth.2019.12.009","volume":"35","author":"SZ Griffiths","year":"2020","unstructured":"Griffiths SZ, Post ZD, Buxbaum EJ, Paziuk TM, Orozco FR, Ong AC, Ponzio DY (2020) Predictors of perioperative vancouver b periprosthetic femoral fractures associated with the direct anterior approach to total hip arthroplasty. J Arthroplasty 35(5):1407\u20131411. https:\/\/doi.org\/10.1016\/j.arth.2019.12.009","journal-title":"J Arthroplasty"},{"key":"795_CR15","first-page":"229","volume":"62","author":"D Chen","year":"2013","unstructured":"Chen D, Berger RA (2013) Outpatient minimally invasive total hip arthroplasty via a modified Watson-Jones approach: technique and results. Instr Course Lect 62:229\u2013236","journal-title":"Instr Course Lect"},{"issue":"11","key":"795_CR16","doi-asserted-by":"publisher","first-page":"677","DOI":"10.5435\/00124635-200911000-00002","volume":"17","author":"J Pike","year":"2009","unstructured":"Pike J, Davidson D, Garbuz D, Duncan CP, O\u2019Brien PJ, Masri BA (2009) Principles of treatment for periprosthetic femoral shaft fractures around well-fixed total hip arthroplasty. J Am Acad Orthop Surg 17(11):677\u2013688. https:\/\/doi.org\/10.5435\/00124635-200911000-00002","journal-title":"J Am Acad Orthop Surg"},{"issue":"7","key":"795_CR17","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1016\/j.arth.2019.03.031","volume":"34","author":"B Liu","year":"2019","unstructured":"Liu B, Ma W, Li H, Wu T, Huo J, Han Y (2019) Incidence, classification, and risk factors for intraoperative periprosthetic femoral fractures in patients undergoing total hip arthroplasty with a single stem: a retrospective study. J Arthroplasty 34(7):1400\u20131411. https:\/\/doi.org\/10.1016\/j.arth.2019.03.031","journal-title":"J Arthroplasty"},{"issue":"9","key":"795_CR18","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.2106\/JBJS.H.00331","volume":"90","author":"D Davidson","year":"2008","unstructured":"Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA (2008) Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg Am 90(9):2000\u20132012. https:\/\/doi.org\/10.2106\/JBJS.H.00331","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"795_CR19","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1186\/s12891-019-2645-6","volume":"20","author":"MM Innmann","year":"2019","unstructured":"Innmann MM, Weishorn J, Bruckner T, Streit MR, Walker T, Gotterbarm T, Merle C, Maier MW (2019) Fifty-six percent of proximal femoral cortical hypertrophies 6 to 10 years after total hip arthroplasty with a short cementless curved hip stem - a cause for concern? BMC Musculoskelet Disord 20(1):261. https:\/\/doi.org\/10.1186\/s12891-019-2645-6","journal-title":"BMC Musculoskelet Disord"},{"key":"795_CR20","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/00003086-198810000-00015","volume":"235","author":"PC Noble","year":"1988","unstructured":"Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235:148\u2013165","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"795_CR21","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/00013611-198610000-00007","volume":"1","author":"LD Dorr","year":"1986","unstructured":"Dorr LD (1986) Total hip replacement using APR system. Tech Orthop 1(3):22\u201334","journal-title":"Tech Orthop"},{"issue":"4","key":"795_CR22","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.arth.2005.04.037","volume":"21","author":"Y Yeung","year":"2006","unstructured":"Yeung Y, Chiu KY, Yau WP, Tang WM, Cheung WY, Ng TP (2006) Assessment of the proximal femoral morphology using plain radiograph-can it predict the bone quality? J Arthroplasty 21(4):508\u2013513. https:\/\/doi.org\/10.1016\/j.arth.2005.04.037","journal-title":"J Arthroplasty"},{"key":"795_CR23","unstructured":"Spotorno L, Romagnoli S. Indications for the CLS stem. The CLS uncemented total hip replacement system Berne, Switzerland: Protek, 1991; 4 (1)"},{"issue":"3","key":"795_CR24","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/8756-3282(93)90146-2","volume":"14","author":"LD Dorr","year":"1993","unstructured":"Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH (1993) Structural and cellular assessment of bone quality of proximal femur. Bone 14(3):231\u2013242. https:\/\/doi.org\/10.1016\/8756-3282(93)90146-2","journal-title":"Bone"},{"issue":"3","key":"795_CR25","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.arth.2014.10.005","volume":"30","author":"D Nam","year":"2015","unstructured":"Nam D, Sauber TJ, Barrack T, Johnson SR, Brooks PJ, Nunley RM (2015) Radiographic parameters associated with pain following total hip and surface arthroplasty. J Arthroplasty 30(3):495\u2013501. https:\/\/doi.org\/10.1016\/j.arth.2014.10.005","journal-title":"J Arthroplasty"},{"issue":"20","key":"795_CR26","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.2106\/JBJS.M.00780","volume":"96","author":"HS Khanuja","year":"2014","unstructured":"Khanuja HS, Banerjee S, Jain D, Pivec R, Mont MA (2014) Short bone-conserving stems in cementless hip arthroplasty. J Bone Joint Surg Am 96(20):1742\u20131752. https:\/\/doi.org\/10.2106\/JBJS.M.00780","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"795_CR27","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s13018-021-02253-4","volume":"16","author":"G Sun","year":"2021","unstructured":"Sun G, Yin Y, Ye Y, Li Q (2021) Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis. J Orthop Surg Res 16(1):98. https:\/\/doi.org\/10.1186\/s13018-021-02253-4","journal-title":"J Orthop Surg Res"}],"container-title":["Journal of Orthopaedics and Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-024-00795-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s10195-024-00795-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-024-00795-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T08:03:06Z","timestamp":1730880186000},"score":1,"resource":{"primary":{"URL":"https:\/\/jorthoptraumatol.springeropen.com\/articles\/10.1186\/s10195-024-00795-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,4]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["795"],"URL":"https:\/\/doi.org\/10.1186\/s10195-024-00795-x","relation":{},"ISSN":["1590-9999"],"issn-type":[{"type":"electronic","value":"1590-9999"}],"subject":[],"published":{"date-parts":[[2024,11,4]]},"assertion":[{"value":"3 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received ethical approval from the local institutional review board (no.: 1232\/2022) of the \u201cEthikkommission O\u00d6\u201d of the Johannes Kepler University Linz (JKU Linz). Because of the retrospective anonymized evaluation of preexisting medical records, an informed consent was not required. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication was given by the all authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We report personal fees paid to one co-author (T.G.) during the conduct of the study from Zimmer Biomet, Europe and from Depuy Synthes Orthop\u00e4die Gmbh, Peter Brehm GmbH, ImplanTec GmbH outside the submitted work. We report research grants paid to our institution during the conduct of the study from Zimmer Biomet, Europe, Mathys AG Switzerland, Anika Therapeutics outside the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"51"}}