Vancouver type B2 periprosthetic femoral fractures: clinical and radiological outcomes from a tertiary care center.
Arch Orthop Trauma Surg
; 143(11): 6919-6926, 2023 Nov.
Article
in En
| MEDLINE
| ID: mdl-37392216
INTRODUCTION: The purpose of this study was to report mid-term clinical and radiographic results after hip arthroplasty revision in Vancouver type B2 femoral periprosthetic fractures (PPFx). Specifical focus of the paper is as follows: (1) the description of a standardized and reproducible surgical technique, (2) functional outcomes presentation and (3) type and number of complications and implants' survival rate analysis. METHODS: We retrospectively reviewed all patients treated for hip revision with non-modular tapered fluted titanium stem in patients with Vancouver type B2 femur PPFx at a single institution. At least 18 months' follow-up period was required. Harris Hip Scores and SF-12 were obtained, and radiographical follow-up was performed. Complications were reported and analyzed. RESULTS: The authors included 114 patients (114 hips) with a mean follow-up of 62.8 ± 30.6 months. All patients were treated with Wagner SL revision hip stem (Zimmer-Biomet), metal cerclage wires ± trochanteric plate. The mean HHS and SF-12 score at the last follow-up evaluation were respectively 81.3 ± 9.7 and 32.5 ± 7.6. Seventeen (14.9%) complications occurred. We observed five cases of dislocations, two of periprosthetic joint infections and six cases of new PPFx. The stem-related revision rate for any cause at the final FU was 1.7%, due to PJI. No patients underwent stem revision surgery for aseptic loosening. Fracture healed in all the included patients with a union-rate of 100%. The re-operation rate for any cause was 9.6%, with an implant survival rate for overall failure of 96.5%. CONCLUSION: The presented standard and reproducible surgical technique obtains optimal clinical and radiological results with limited complication rate at mid-term follow up. Preoperative planning as well as careful intraoperative surgical technique is of a paramount importance.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthroplasty, Replacement, Hip
/
Periprosthetic Fractures
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Femoral Fractures
/
Hip Prosthesis
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Arch Orthop Trauma Surg
Year:
2023
Document type:
Article