The Fix Causes the Problem

Hip and thigh implants increase risk of bone fracture among children

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Children with hip and thigh implants face an increased risk of bone fracture of the same bones being treated by the implants, according to a new study from Johns Hopkins Children's Center.

In a study of over 7,500 pediatric bone implants, Johns Hopkins researchers found nine out of 1,000 hip and thigh implants were associated with hip and thigh fractures. Even though the overall chance of experiencing a hip or thigh fracture was small, it was 15 times greater than the chances of suffering an implant-related fracture in other bones.

Bone implants in children are sometimes used to correct fractures or fix growth deformities. Implant-related fractures are likely caused from the pressure and stress that the implant puts on the bone. This pressure can become especially risky in young patients whose bones are still growing, or in patients with conditions - such as cerebral palsy or other skeletal syndromes - that weaken the bones.

In light of their findings, senior investigator Paul Sponseller, M.D., M.B.A., director of orthopedic surgery at Hopkins Children's, calls on orthopedic surgeons to consider taking out the implant a few years after surgery or when the bone is fully healed. Hip and thigh implants pose a greater risk of fracture among children because the shape of the hip and thigh change rapidly as a child grows. As such, Dr. Sponseller contends that it is important to remove these implants from children, but especially important to do so for patients with an already compromised bone structure.

According to the researcher's findings, thigh implants posed the greatest risk of fracture. The researchers also found that nine of 1,000 fractures were related to hip and/or thigh implants, and three of 1,000 fractures were related to implants in any bone. However, the risk of implant-related fractures in the hand, arm, forearm, leg, ankle, and foot was less than one for every 1,000.

The authors recommend that low-risk implants - such as those in the arm, hand, leg, and foot - are best left in because the risks of removing them are far greater than the benefits.

As the question of whether to remove certain implants has concerned orthopedic surgeons for many years, Dr. Sponseller hopes that this study's findings will help guide surgeons' decisions.

The results of the study will be presented at this year's meeting of the American Academy of Orthopedic Surgeons.

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Review Date: 
February 16, 2011
Last Updated:
February 16, 2011