A New Technique in Revision Hip Arthroplasty for Vancouver B Periprosthetic Fractures

Khan, Riaz J.K.; McGonagle, L.; Wallis, Andrew; Sidhu, Amanpreet; Fick, Daniel; Nivbrant, Bo

doi:10.1097/bto.0000000000000096

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…The inclusion criterion was the presence of a Vancouver B periprosthetic femoral fracture, fixed using our superior capsulotomy technique. The technique, described in detail by Khan et al [5], incorporates an incision along the mid-lateral femoral plane, splitting Gluteus Maximus (GM) proximally and fascia lata distally. Vastus Lateralis (VL) is retracted anteriorly, taking care to ligate the perforating vessels, providing excellent exposure to the femoral shaft and fracture.…”

Section: Methodsmentioning

confidence: 99%

“…The extent of soft tissue dissection has been postulated to be the most important variable impacting dislocation after revision hip arthroplasty, and needs to be minimised [4] . The technique, first described by the senior authors in 2015, takes into consideration the potentially destructive nature of revision hip arthroplasty surgery, by utilising a minimal superior capsulotomy without disrupting the acetabular component [5] . The aim of this study is to report the mid-term findings of this surgical technique.…”

Section: Introductionmentioning

confidence: 99%

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Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures

Isaac¹,

Khan²,

Fick³

et al. 2018

Int. J. Orthop. Sci.

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The risk of hip dislocation after revision total hip arthroplasty can be as high as 27% following surgery for periprosthetic fractures. A novel technique described by the senior authors in 2015, involving a trans trochanteric osteotomy and minimal superior capsulotomy, minimises this risk. Design: Prospective cohort study Setting: Sir Charles Gairdner Hospital, Hollywood Private Hospital Patients: Forty-two patients with Vancouver B type periprosthetic hip fractures, fixed using our superior capsulotomy technique. Intervention: The approach involves extending the fracture proximally to the tip of the greater trochanter, splitting the gluteal tendons and superior capsule in the same plane, in a titrated manner such that the head dislocates from the socket with a 'pop'. The femoral component is revised and the cup and liner retained. Main Outcome Measurements: The primary outcome of interest was dislocation rate. Results: Patients averaged 80 years of age. Mean follow up was 31 months (range 12 months to 5 years). The primary finding was zero cases of hip joint dislocation. The average Oxford hip score was 31/48, the physical component and mental component Short Form 12 mean scores were 31.7 and 53.6 respectively at 1 year following revision. Functional scores did not significantly thereafter at 2 and 5 years. Mean subsidence at 1-year post operatively was 8.73mm. Two stems were revised. Conclusion:The outcomes of this operative technique in revision arthroplasty of Vancouver B periprosthetic hip fractures is promising, with no cases of hip dislocation, along with satisfactory patient clinical outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures

Isaac¹,

Khan²,

Fick³

et al. 2018

Int. J. Orthop. Sci.

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Removal of Well Fixed, Fluted Cementless Femoral Stem. Revisiting The Antegrade Drilling Technique for Easier Stem Extraction.

El-Husseini,

Mahmoud,

Horwitz

2024

Journal of Orthopaedic Experience &Amp; Innovation

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In this study, we aimed to revisit and highlight the technique of antegrade drilling of the femur-stem interface during revision hip arthroplasty for extraction of the fluted cementless tapered stems, and to highlight the risk for femoral comminution with unplanned stem extraction. The unique design of fluted stems creates several stress risers in the femoral cortex, and care should be taken while performing a trochanteric osteotomy for stem extraction in such cases in order to avoid unplanned bone fracture, which could compromise the stability of the new implant.

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A New Technique in Revision Hip Arthroplasty for Vancouver B Periprosthetic Fractures

Cited by 2 publications

References 24 publications

Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures

Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures

Removal of Well Fixed, Fluted Cementless Femoral Stem. Revisiting The Antegrade Drilling Technique for Easier Stem Extraction.

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