1.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.
2.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.
3.Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review
Jad MANSOUR ; Ziad ZALAQUETT ; Jean TARCHICHI ; Michel ESTEPHAN ; Joeffroy OTAYEK ; Mohammad DAHER
Hip & Pelvis 2025;37(1):17-25
Trochanteric fractures of the femur pose an increasing burden for elderly people. The standard treatment for these types of fractures includes cephalomedullary nailing, which can be augmented with cement. Although many studies have reported on the stability of this augmented construct, few studies have examined its clinical benefit and safety. Therefore, the objective of this meta-analysis is to examine the perioperative complications and postoperative mortality associated with cement-augmented nails in the management of intertrochanteric and pertrochanteric fractures of the hip. A search of PubMed, Cochrane, and Google Scholar (pages 1-20) until January 2024 was conducted. Analysis of the outcomes included perioperative complications and postoperative mortality. Seven studies were included in this meta-analysis. Fewer perioperative complications were observed when using a cemented femoral nail (P=0.002), although there was no difference in postoperative mortality (P=0.30). This meta-analysis is the first to assess the safety of a cement-augmented femoral nail in management of intertrochanteric and pertrochanteric fractures. The results showed a reduced rate of perioperative complications, which may be attributed to a more a solid construct, which reduced the duration of postoperative immobilization as well as use of a proper augmentation technique, resulting in a reduced rate of cement-associated complications.
4.Preoperative Templating in Hip Resurfacing: Impact on Implant Sizing and Component Positioning
Jean TARCHICHI ; Marie Le BARON ; Mohammad DAHER ; Alexandre FLECHER ; Xavier FLECHER
Hip & Pelvis 2025;37(4):253-261
Purpose:
Over the past decade, hip resurfacing arthroplasty (HRA) has seen a resurgence in popularity due to an increased success rate attributed to numerous novel techniques. Preoperative digital templating is an effective technique that overcomes the technical difficulties of HRA. However, literature on this technique is sparse. Our study aims to fill this void by exploring the impact of preoperative digital templating on implant sizing and component positioning in hip resurfacing surgeries.
Materials and Methods:
This is a retrospective study of patients operated with HRA from 2019 to 2024 in our institution (Hôpital Nord, Marseille). Pre- and postoperative data were collected to determine the size of the implants and their positioning on preoperative templates and postoperative X-rays.
Results:
There was no difference in the optimal positioning of implants and the same leg-length discrepancy when individuals with intraoperative changes in implant size from the templates were compared to those with templates that were identical to the postoperative implant sizes. No correlation was found between the changes in the size of the implants and covariates, such as age, side, body mass index, and etiology of the disease.
Conclusion
This study highlights the need for intraoperative adjustments of the implant size and optimal positioning during a hip resurfacing surgery, taking into account the crucial information revealed by a preoperative digital templating to optimize the success rate.
5.Hip Labral Repair versus Reconstruction: Meta-analysis
Jean TARCHICHI ; Mohammad DAHER ; Ali GHOUL ; Michel ESTEPHAN ; Karl BOULOS ; Jad MANSOUR
Hip & Pelvis 2024;36(3):168-178
The purpose of this meta-analysis is to compare the postoperative outcomes and complications of labral repair with those of labral reconstruction. An electronic search strategy was conducted from 1986 until August 2023 using the following databases: PubMed, Cochrane, and Google Scholar (pages 1-20). The primary objectives included the postoperative clinical outcomes determined by the number of patients who reached minimal clinical important difference (MCID) on the visual analog scale (VAS), modified Harris hip score (mHHS), Hip Outcome Score-Sports Subscale (HOS-SS), Hip Outcome Score-Activities of Daily Life (HOS-ADL), and International Hip Outcome Tool-12 (iHOT-12). In addition, analysis of the rate of revision arthroscopy, the rate of conversion to total hip arthroplasty (THA), the postoperative VAS, mHHS, HOS-SS, HOS-ADL, iHOT-12, nonarthritic hip score (NAHS), patient satisfaction, lower extremity function scale (LEFS), and the SF-12 (12-item shortform) was also performed. Any differences arising between the investigators were resolved by discussion. Seventeen studies were relevant to the inclusion criteria and were included in this meta-analysis. A higher rate of patients who reached MCID in the mHHS (P=0.02) as well as a higher rate of revision arthroscopy was observed for labral repair (P=0.03). The remaining studied outcomes were comparable. Despite the greater predictability of success in the reconstruction group, conduct of additional studies will be required for evaluation of the benefits of such findings. In addition, labral reconstruction is more technically demanding than a labral repair.

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