The use of a standard-length conical tapered stem in hip revision arthroplasty to address Paprosky type I–II femoral defects: a prospective study of 87 patients

Innocenti, Massimo; Smulders, Katrijn; Andreotti, Mattia; Willems, Jore H.; Hellemondt, Gijs van; Nijhof, Marc W.

doi:10.1007/s00402-023-04797-y

Cited by 1 publication

(1 citation statement)

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“…This method which bypasses the fracture offers the advantage of directly addressing the instability between the stem and bone while securing the fracture site, remains the recommended surgical procedure for the challenging Vancouver type B2 PPFs [ 1 , 6 , 24 , 30 ]. However, it has the drawback of causing more significant damage to the femoral bone stock, making future RA procedures more challenging [ 11 , 13 ]. ORIF was performed for certain type injuries in patients who were not medically fit for RA, particularly when dealing with elderly patients with multiple comorbidities, while RA was chosen for other cases [ 5 , 9 , 12 , 26 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Long stem revision versus short stem revision with plate osteosynthesis for Vancouver type B2 periprosthetic femoral fracture: a comparative study of eighty five cases

Chen,

Hung,

Liou

et al. 2024

International Orthopaedics (SICOT)

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Purpose Periprosthetic femoral fractures (PPFs) around the hip are challenging complications in orthopaedic surgery, particularly Vancouver type B2 (VTB2) fractures. The surgical management of these fractures is crucial and depends on various factors. Cementless short taper stem with plate osteosynthesis is an alternative surgical technique. This study aims to compare the outcomes of this surgical technique with revision arthroplasty (RA) with long stem in the treatment of VTB2 PPFs. Methods This retrospective study was conducted in a single medical institute from February 2010 to May 2019. Patients who had received either total hip arthroplasty or bipolar hemiarthroplasty and subsequently developed a VTB2 PPF were included; patients who sustained intra-operative fractures or received a cemented stem previously were excluded from the analysis. The patients were divided into two groups: group I received RA with cementless long stem, while group II underwent RA with cementless short taper stem with plate osteosynthesis. Demographic data, radiographic and functional outcomes, and complications were analyzed between the two groups. Results A total of 85 patients diagnosed with VTB2 PPFs were included in the study. There were no significant differences between the two groups in terms of demographic data, including age, gender, mean follow-up times, estimated blood loss, and operative times. The radiographic results showed that there was no significant difference in the incidence of subsidence and implant stability between the two groups. However, group II tended to have less subsidence and periprosthetic osteolysis. Patients in group II had significantly better functional scores (mean Harris hip score: post-operative: 60.2 in group I and 66.7 in group ii; last follow-up: 77.4 in group 1 and 83.2 in group II (both p < 0.05)). There were no significant differences in the overall complication rate, including infection, dislocation, re-fracture, and revision surgery, between the two groups. Conclusions Both surgical techniques, cementless long stem and cementless short taper stem with plate osteosynthesis, are effective in the treatment of Vancouver B2 PPFs, with no significant differences in outcomes or complications. However, patients in cementless short taper stem with plate osteosynthesis had better functional scores at both post-operative and the last follow-up.

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