2026 AAHKS Annual Meeting: Fixation of Intraoperative Calcar Fractures in Primary THA Restored Survivorship to Matched Controls

681 patients undergoing primary total hip arthroplasty (THA) were retrospectively evaluated, including 227 patients who sustained intraoperative calcar fractures and 454 matched controls without fractures. Most fractures were managed with cerclage fixation. The primary outcomes were implant survivorship free of femoral revision, any revision, and any reoperation. Secondary outcomes included postoperative periprosthetic fractures, stem subsidence, revision risk factors, and Harris Hip Score (HHS). Outcomes were assessed at 2 and 10 years, with a mean follow-up of 7 years. Overall, the results revealed that patients with intraoperative calcar fractures achieved comparable 10-year implant survivorship and functional outcomes to matched controls. However, cerclage placement below the lesser trochanter was associated with increased revision risk. These findings suggested that appropriately managed intraoperative calcar fractures did not compromise long-term THA survivorship.