Management of Vancouver type B2 and B3 femoral periprosthetic fractures using an uncemented extensively porous-coated long femoral stem prosthesis

Canbora, Kerem; Köse, Özkan; Polat, Atilla; Aykanat, Faruk; Gorgec, Mucahit

doi:10.1007/s00590-012-1024-x

Cited by 18 publications

(17 citation statements)

References 18 publications

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“…All patients had achieved fracture union by the final follow-up, and the length of femoral stem fixation beyond the distal end of the fracture was greater than 4 cm, which matched well with the femur. The patients in our study achieved better clinical outcomes compared to those in previous studies, 11,[33][34][35][36][37] such as Harris Hip score ( Table 5). Further studies with larger sample sizes will be required to determine whether this method will be effective for routine treatment of Vancouver type B2 PFFs.…”

Section: Discussionsupporting

confidence: 43%

“…Our study involves longer follow-up (102 + 24.5 months) than most previous studies, which followed up for 14.5-60 months. 11,[33][34][35][36][37] Nevertheless, our study still has several limitations. First, the sample is relatively small, so statistical power is low.…”

Section: Discussionmentioning

confidence: 91%

“…9,10 Vancouver type B2 PFFs are defined as fractures occurring around the stem or just distal to it and with a loose stem. 11 This PFF type is particularly difficult to treat due to loosening of the prosthesis. Most patients with type B2 fractures are elderly, with poor bone quality and chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…14 –16 However, there is no clear consensus on the optimal surgical technique and stem design for revision surgery. 11…”

Section: Introductionmentioning

confidence: 99%

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Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study

Wang

Kang

2019

J Orthop Surg (Hong Kong)

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The aim of this study was to evaluate the mid-to long-term outcomes of revision surgery for Vancouver type B2 periprosthetic femoral fractures (PFFs) after total hip arthroplasty using an uncemented extensive porous titaniumcoated long femoral stem prosthesis (solution prosthesis) with or without cortical strut allograft. Methods: A total of 34 patients with Vancouver type B2 PFFs who underwent revision hip arthroplasty using a posterolateral approach and received a solution prosthesis at our institution from December 2006 to January 2014 were retrospectively recruited. Patients were asked to assess their walking ability and pain status using a questionnaire. Limb function, pain, and physical and mental health were assessed using the Harris Hip score, University of California-Los Angeles score, Western Ontario and McMaster Universities osteoarthritis index, and Short Form-12 Health Survey score. Patients were also asked to rate their satisfaction with the surgery. Fracture union and stress shielding were assessed by radiography, and computed tomography was used to assess stem fixation. Single-photon emission computed tomography performed to assess radionuclide distribution in patients given cortical strut allografts. Patients were asked about their condition before PFF and evaluated at 6 weeks, 3 months, 6 months, 1 year, and annually after surgery. Any complications during follow-up were recorded. Results: Of the 34 patients, 29 completed follow-up. There was no significant difference in patient's health before PFF or at the last follow-up. Fracture union was achieved in all patients. Mild-to-moderate stress shielding occurred in three patients, and no patients exhibited femoral stem loosening or obvious subsidence. Radionuclides were concentrated in the cortical strut transplantation area, and the cortical strut was integrated with the host femur. The incidence of postoperative complications was low. Conclusions: Revision surgery using the solution prosthesis with or without cortical strut allograft is effective in treating Vancouver type B2 PFFs, with satisfactory mid-and long-term clinical and radiological outcomes.

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Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

“…14 –16 However, there is no clear consensus on the optimal surgical technique and stem design for revision surgery. 11…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study

Wang

Kang

2019

J Orthop Surg (Hong Kong)

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“…33,34 Stem subsidence is a concern in femoral revision arthroplasty 30,31 and uncontrolled subsidence has been regarded as a major cause for failure of uncemented revision stems. 35,36 Stem subsidence has been reported with a variety of implant designs, such as monoblock fluted tapered stems, 37,38 extensively porous-coated cylindrical stems, 39,40 and modular fluted tapered stems. 16,41,42 Subsidence of the Restoration modular fluted tapered stem has been reported to occur in 3.6-100% of the cases 29,30 ; such heterogeneity in subsidence rates may be related to the variability of the severity of preoperative bone defects and criteria used to define subsidence.…”

Section: Discussionmentioning

confidence: 99%

Clinical, radiographic, and survivorship analysis of a modular fluted tapered stem in revision hip arthroplasty

Picado

Savarese

Cardamoni

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: Modular fluted tapered stems are one of the most commonly used implants in femoral revision surgery. Due to the relative lack of studies on the Restoration modular fluted tapered stem, we conducted a study to evaluate its short- to mid-term clinical, radiographic, and survival outcomes. Methods: We identified all 45 patients treated with this revision stem at our institution. Five patients did not complete the minimum 2-year follow-up, leaving 40 patients (41 hips) for assessment. Mean follow-up was 5.1 years (range 2–11 years). Clinical outcomes were assessed using the Harris hip score (HHS). Radiographs were evaluated for subsidence and loosening. Kaplan–Meier survival analysis was performed using revision of the stem for any reason as end point. Results: The mean HHS improved from 44.6 points preoperatively to 78.4 points at the most recent follow-up ( p < 0.0001). Nonprogressive subsidence occurred in 83% of the hips (mean 2.8 mm; range 1–7 mm). One stem (2.4%) showed progressive subsidence (20 mm) and was considered loose. The most common cause for reoperation was dislocation (three hips, 7.3%). The 10-year survivorship with revision of the stem for any reason as the end point was 93.5% (95% CI, 84.9–100%). Conclusion: There was a significant improvement in the HHS and a low likelihood of revision at short- to mid-term follow-up, adding to the current evidence base for use of this implant in revision surgery. A longer follow-up and a larger number of cases are necessary to fully evaluate its role and performance.

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Periprosthetic Femur Fractures After Total Hip Arthroplasty

deMeireles

Sarpong

Cooper

2021

Geriatric Hip Fractures

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Management of Vancouver type B2 and B3 femoral periprosthetic fractures using an uncemented extensively porous-coated long femoral stem prosthesis

Abstract: An uncemented extensively porous-coated long femoral stem together with or without onlay strut allografts provides a good fracture stability that promotes fracture healing and offers a successful solution for the management of Vancouver type B2 and B3 femoral periprosthetic fractures.

Cited by 18 publications

References 18 publications

Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study

Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study

Clinical, radiographic, and survivorship analysis of a modular fluted tapered stem in revision hip arthroplasty

Periprosthetic Femur Fractures After Total Hip Arthroplasty

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