Radiographic and Clinical Outcomes of Modular Tapered Fluted Stems for Femoral Revision for Paprosky III and IV Femoral Defects or Vancouver B2 and B3 Femoral Fractures

Otero, Jesse E.; Martin, John R.; Rowe, Taylor; Odum, Susan M.; Mason, J. Bohannon

doi:10.1016/j.arth.2019.11.039

Cited by 25 publications

(24 citation statements)

References 35 publications

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“…Besides the 3-degree curvature of the modular stem helped accommodate the bow of the patient's femur and achieve enough canal lling [28]. Besides the above advantages, modular tapered uted stems for femoral revision show excellent outcomes in patients with Paprosky 3, 4 femoral defects [29], so modular stems may be a good choice for revisions in patients with extensive femoral bone loss.…”

Section: Discussionmentioning

confidence: 99%

Femoral offset restoration affects the outcome of revision in patients with periprosthetic femoral fractures of Vancouver B2 -a single- center retrospective cohort study

Sun

Song

Zhang

et al. 2023

Preprint

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Background: Femoral offset (FO) restoration plays an important role in improving the prognosis and life quality of patients undergoing hip replacement. However, it is not given enough attention in revisions of patients with periprosthetic femoral fractures (PPFF) while more attention is paid to reduction, fixation of fracture and stabilizing prosthesis. This study aims to evaluate the effect of FO restoration on the function of hip joint in revisions of patients with PPFF of Vancouver B2. What’s more, we study whether there is a difference in FO restoration between modular and nonmodular stems. Methods: A retrospective review of 20 patients with PPFF of Vancouver B2 revised with a tapered fluted modular titanium stem and 22 patients with PPFF of Vancouver B2 revised with a tapered fluted nonmodular titanium stem from 2016 to 2021 was conducted. According to the difference between FO of affected side and healthy side, 26 patients were divided into Group A(difference≤4mm) and 16 patients were divided into Group B(difference＞4mm). Postoperative Harris Hip Score（HHS）,range of motion of hip joint, length of both lower limbs and dislocation were compared between Group A and Group B. Proportion of patients with FO restoration (difference≤4mm)and stem subsidence were compared between modular and nonmodular groups. Results: The mean follow-up time was 34.3±17.3 months, and all cases achieved fracture healing at the last visit. Patients of Group A had higher HHS, larger range of abduction, fewer dislocations and less limbs length discrepancy (LLD). Patients of modular group had a higher proportion of FO restoration and less subsidence. Conclusion: FO restoration improves the postoperative hip joint function，reduces dislocation and LLD in revisions of patients with PPFF of Vancouver B2. Compared with nonmodular prosthesis, modular prosthesis tends to be easier for FO restoration under complex circumstances.

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Section: Discussionmentioning

confidence: 99%

Femoral offset restoration affects the outcome of revision in patients with periprosthetic femoral fractures of Vancouver B2 -a single- center retrospective cohort study

Sun

Song

Zhang

et al. 2023

Preprint

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“…Comparing with other types of prosthesis, the uncemented fluted, tapered, modular stem has many advantages. The modular stem meets the need of the distal and proximal medullary cavity respectively, which is more matched with it and realizes "individualization" [15] . The distal prosthesis groove structure makes for intraoperative instant stability, which is convenient for patients with early activity on fields and functional exercise.…”

Section: Discussionmentioning

confidence: 99%

Midterm follow-up with modular fluted tapered stem in the management of Vancouver B3 femoral periprosthetic fracture

Cheng

Ding

et al. 2020

Preprint

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BackgroundTo evaluate the technique and clinical results of the uncemented fluted, tapered, modular stems in treating Vancouver B3 periprosthetic femoral fractures. MethodsA retrospective study was carried out on 56 patients (56 hips) with the use of the modular femoral stem in revision of total hip arthroplasty between August 2007 and January 2009. The mean patient age was 73.4±6.6 years(rang, 62-82years). Bone defect was categorised as Paprosky types：32 Type IIIA , 20 Type IIIB, 4 Type Ⅳ. 28 hips had allograft struts placed around the fracture. 44 patients had concomitant revision of the acetabular component. The mean duration of follow-up was 102.1±12.2 months (rang, 84-120 months). Hip function and treatment outcome were assessed using Harris Hip Score System and Beals and Tower 's standard. Radiography were used to evaluate the implant stability, bone stock restoration, fracture healing, stem subsidence and complications. ResultsThe mean HHS improved from 45.6 ±5.4 points (range, 32-53 points) preoperatively to 86.3±8.4 points (range, 81-92 points) at the most recent follow-up. Radiographic review showed all fractures of patients united, with maintenance or improvement of bone stock in 96% of patients. The average value of the stem subsidence 4.9±1.5mm (rang, 0-9mm), happening mainly within the first six months after the operation. No implant had been revised because of aseptic loosening or dislocation. 8 of all the 28 allografts united to the host bone. In the last follow-up, 20 cases of treatment results were excellent, 36 cases were good. There were four patients occuring complications such as deep vein thrombosis of lower limbs or subcutaneous haematomas after surgery, all cured during hospitalization. There were no patients occurring the dislocation of hips after revision. ConclusionThe uncemented fluted, tapered, modular prosthesis is a good choice with a high rate of fracture union and implant osteointegration when the treatment of the Vancouver B3 femoral periprosthetic fracture.

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“…Korteksteki defektler için "impaction bone grafting", taze proksimal femur allogrefti ile rekonstrüksiyon, çoklu kortikal allogreft ile femur rekonstrüksiyonu sonrası çimentosuz yivli (fluted) daralan (tapered) modüler femoral komponent seçeneklerinden biri kullanılır (Şekil 9). [19] Bunların her birinin kendine has zorlukları ve avantajları vardır. Günümüzde, bu kadar zor revizyonlarda ve özellikle ileri yaştaki hastalarda, proksimal femur replasmanı daha sık uygulanmaktadır; pahalı olmasına rağmen, kısa dönemde yüksek sağkalım ve düşük tekrarlayan operasyon riski taşır.…”

Section: Femoral Kemi̇k Kaybina Bağli Olarak Rekonstrüksi̇yon Seçenekleri̇unclassified

Revizyon kalça cerrahisinde femoral sorunlar ve rekonstrüksiyon seçeneklerinin incelenmesi

Uluçay¹,

Özler²,

Mazmanoğlu³

et al. 2021

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Radiographic and Clinical Outcomes of Modular Tapered Fluted Stems for Femoral Revision for Paprosky III and IV Femoral Defects or Vancouver B2 and B3 Femoral Fractures

Cited by 25 publications

References 35 publications

Femoral offset restoration affects the outcome of revision in patients with periprosthetic femoral fractures of Vancouver B2 -a single- center retrospective cohort study

Femoral offset restoration affects the outcome of revision in patients with periprosthetic femoral fractures of Vancouver B2 -a single- center retrospective cohort study

Midterm follow-up with modular fluted tapered stem in the management of Vancouver B3 femoral periprosthetic fracture

Revizyon kalça cerrahisinde femoral sorunlar ve rekonstrüksiyon seçeneklerinin incelenmesi

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