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Non-Metallic Cerclage Fixation Methods for Proximal Femoral Osteotomy and Periprosthetic Hip Fractures Offer Promising Outcomes: A Systematic Review

Authors: Parsa A, Chishti Z, Saeed SK, Carbone AD, Domb BG, Schinsky MF

Journal:Journal of Orthopaedics, January 2024

DOI:10.1016/j.jor.2023.11.021

Objective:

To evaluate the safety and effectiveness of non-metallic cerclage fixation compared to traditional metallic methods in proximal femoral osteotomy and periprosthetic fracture cases.

Key Findings:

  • Non-metallic cerclage fixation showed fewer cases of implant subsidence and no fixation failures.
  • Both fixation types demonstrated high rates of bone healing, but non-metallic cerclage was associated with fewer complications.
  • Patient-reported outcomes were comparable between groups.

Conclusion:

Non-metallic cerclage fixation offers a safe and reliable alternative to metallic cerclage, with potential advantages in reducing specific complications.

What Does This Mean for Providers?

  • Consider non-metallic cerclage fixation as a viable option in complex hip surgeries involving osteotomy or periprosthetic fractures to potentially reduce implant subsidence and complication rates.
  • Patient selection and surgical technique remain critical; however, adopting non-metallic options may improve fixation reliability.
  • Monitoring long-term outcomes will help define best practices in fixation methods.