Osteosynthesis versus revision arthroplasty in Vancouver B2 periprosthetic hip fractures: a systematic review and meta-analysis

González-Martín, David; Hernández-Castillejo, Luis Enrique; Herrera-Pérez, Mario; País-Brito, José Luis; González-Casamayor, Sergio; Garrido‐Miguel, Miriam

doi:10.1007/s00068-022-02032-8

Cited by 10 publications

(2 citation statements)

References 41 publications

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“…This may be due to a combination of factors, including the age and frailty of the patient, and the potential for reoperation such as infection or nonunion. According to the results of our meta-analysis, the pooled prevalence of reoperation was 9% (95% CI, 6-12) from all studies, which is in agreement with promising results from recent studies 48 56) . In recent decades, there have been significant advancements in orthopedic surgery techniques and implants including management of PFF for elderly patients 5 25 28 33) .…”

Section: Discussionsupporting

confidence: 91%

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

Yoon,

Park,

Roh

2023

Hip & Pelvis

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Purpose Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P =0.542), nonunion (OR=0.49; CI 0.22-1.10, P =0.085) and deep infection (OR=1.89, CI 0.48-7.46, P =0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P =0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P =0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P =0.130). Conclusion ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.

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Section: Discussionsupporting

confidence: 91%

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

Yoon,

Park,

Roh

2023

Hip & Pelvis

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“…Revision rates due to periprosthetic fractures in the presented ABG-II femoral stem cohort were considerably higher from other uncemented femoral stems used in the same hospital by the same group of surgeons (University Medical Centre Ljubljana, Department of Orthopaedic Surgery) [ 13 , 14 ] in arthroplasty registries worldwide [ 16 , 17 ] or in other implant types [ 18 – 20 ]. The design setting of our study enabled adjustment for variability between surgeons in the multivariate analysis and clearly showed that the high ABG-II periprosthetic fracture rate was neither surgeon-dependent nor hospital-specific.…”

Section: Discussionmentioning

confidence: 99%

Surgeon-Stratified Periprosthetic Fracture Risk in a Single-Hospital Cohort of 1531 Uncemented ABG-II Femoral Stems at Primary Total Hip Arthroplasty

Kropivšek,

Antolič,

Mavčič

2023

JOIO

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Purpose Late periprosthetic fracture risk with uncemented ABG-II femoral stems at primary total hip arthroplasty (THA) has been reported before, but single-hospital surgeon-stratified reports of this implant have never been published. We asked whether periprosthetic fracture rates of ABG-II femoral stems implanted at a single tertiary hospital depended on patients’ age, gender and the operating surgeon. Methods The study included 1531 consecutive primary ABG-II femoral stems implanted at a single tertiary hospital between January 1, 2012 and December 31, 2018. The Kaplan–Meier and Cox regression analyses were performed after 3.6–10.6 years of follow-up. Results In the cohort, we recorded 8 intraoperative, 22 early postoperative (within 90 days of implantation) and 26 late periprosthetic fractures (over 90 days postoperatively). The revision rate of ABG-II femoral stems was 5.1/100 component-years for early and 0.3/100 component-years for late periprosthetic fractures. The Kaplan–Meier cumulative probability of periprosthetic fracture was 2.1% at one, 2.3% at 2, 3.2% at 5, and 6.5% at 10 years after the implantation. Higher patient's age at operation was an independent risk factor of subsequent periprosthetic fracture (hazard ratio 1.07, 95% confidence interval 1.03–1.10; p < 0.01), regardless of the operating surgeon. Most of the fractured femora were Dorr type C (stovepipe). Conclusion The study presents the largest published ABG-II femoral stem cohort from a single hospital so far with 9291 component-years of observation. Periprosthetic fracture risk of ABG-II increased with patients’ age, had no variability between different surgeons, and was considerably higher from other uncemented femoral stems used at the same hospital. Level of Evidence III.

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Komplikationen der Hüftendoprothetik: Periprothetische Frakturen

Märdian,

Meller

2023

AE-Manual Der Endoprothetik

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Osteosynthesis versus revision arthroplasty in Vancouver B2 periprosthetic hip fractures: a systematic review and meta-analysis

Cited by 10 publications

References 41 publications

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

Surgeon-Stratified Periprosthetic Fracture Risk in a Single-Hospital Cohort of 1531 Uncemented ABG-II Femoral Stems at Primary Total Hip Arthroplasty

Komplikationen der Hüftendoprothetik: Periprothetische Frakturen

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