Locking compression plate versus revision-prosthesis for Vancouver type B2 periprosthetic femoral fractures after total hip arthroplasty

Joestl, Julian; Hofbauer, Marcus; Lang, Nikolaus; Tiefenboeck, Thomas M.; Hajdu, Stefan

doi:10.1016/j.injury.2016.01.036

Cited by 51 publications

(59 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our systematic search identified 14 original studies that included patients treated with ORIF and patients treated with revision arthroplasty in the treatment of B2 and B3 PFF [5,16,[19][20][21][22][23][24][25][26][27][30][31][32]. The publications were mainly retrospective cohort studies which did not describe the treatment allocation, provided little information about potential predictive factors and presented diverse outcome parameters.…”

Section: Resultsmentioning

confidence: 99%

“…The conception that ORIF could be advantageous in PFF around certain loose stems is supported by several reports where ORIF was compared to stem revision in B2 and/or B3 fractures and resulted in equivalent, if not better, outcomes [5,16,[19][20][21][22][23][24][25][26][27].…”

Section: Current Treatment Recommendations Under Debatementioning

confidence: 99%

“…Eight studies presented information on whether the PFF occurred around primary or around revision hip stems [5, 16, 22-25, 27, 31], eight presented the information whether the stem was cemented or uncemented [5,16,22,24,25,27,30,31], three provided information about the fixation mechanism of the cemented stem (CCPT or CB) or the stem's brand name for the respective treatment group [16,22,27], three informed about the diagnosis that had led to the initial hip replacement [22,27,31] and 7 provided details about the implants used for ORIF [16,20,[22][23][24][25]30]. One study presented some of the aforementioned parameters for some of the PFF types but did not follow a consistent pattern in doing so [26].…”

Section: Prognostic Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Fracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review

Stoffel

Blauth

Joeris

et al. 2020

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction Hip arthroplasty (HA) is commonly performed to treat various hip pathologies. Its volume is expected to rise further due to the increasing age of the population. Complication rates are low; however, periprosthetic femoral fractures (PFF) are a rare, albeit serious, complication with substantial economic impact. While current guidelines propose revision with long-stemmed prostheses for all Vancouver B2 and B3 PFF, some recent research papers suggest that open reduction with internal fixation (ORIF) could lead to an equivalent outcome. Our aim was to summarize the evidence, elucidating under which circumstances ORIF leads to a favorable outcome after B2 and B3 PFF compared with revision surgery. Materials and methods A systematic literature search was performed to identify studies on patients treated with ORIF and with stem revision after B2 and/or B3 fractures. Extracted information included initial pathology, stem fixation mechanism, bone quality and stem stability at the time of PFF, clinical outcomes, and mortality. Results of individual studies were summarized in a table in lieu of a quantitative data synthesis due to a lack of standardized information. Results We identified 14 original research articles including both patients treated with ORIF and with stem revision after B2 and/or B3 PFF. Five studies included statistical comparisons, all were in favor of ORIF or indeterminate. The common lack of rigorous statistical analyses and significant methodological weaknesses made identification of outcome predictors impossible. Conclusion The choice of treatment modality for PFF depends on fracture, implant, and bone characteristics. Recent data show that successful outcome can be achieved without revising loose stems. ORIF may be a viable option if bone stock is adequate around uncemented or tapered polished stems with an intact cement mantle and the fracture geometry allows stable anatomic reconstruction. Conceptional considerations support this idea, but more data are needed to identify outcome predictors.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Current Treatment Recommendations Under Debatementioning

confidence: 99%

Section: Prognostic Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Fracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review

Stoffel

Blauth

Joeris

et al. 2020

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…It can be partially attributed to surgeon's misinterpretation of the stability of the stem and a mistaken classification of type B2 fractures as type B1 fractures, under which condition, a plate fixation without revision was taken by surgeons. Meanwhile, some alternative treatments for B2 fractures are reported recently 16, 18, 19. Joestl et al 18 reported good results of ORIF for B2 fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, some alternative treatments for B2 fractures are reported recently 16, 18, 19. Joestl et al 18 reported good results of ORIF for B2 fractures. Niikura et al 19 treated one B2 fracture conservatively and gained a satisfying outcome.…”

Section: Discussionmentioning

confidence: 99%

Case report: A 10 years follow-up of periprosthetic femoral fracture after total hip arthroplasty in osteopetrosis

Zhang

Wang

et al. 2017

Chinese Journal of Traumatology

View full text Add to dashboard Cite

Osteopetrosis is an inherited disorder characterized by increased bone density and brittle bone quality. Degenerative changes often occur after the age of 40 in patients with osteopetrosis. Operative intervention is the primary treatment option if the clinical manifestation of secondary osteoarthritis is severe. A 44-year-old male suffering autosomal dominant osteopetrosis and progressive unilateral hip osteoarthritis required a total hip arthroplasty. However, there were several technical challenges associated with this procedure including creating a femoral medullary canal and developing a Vancouver type B2 periprosthetic femoral fracture postoperatively. To afford some experience for the management of similar cases, we here present our technical solutions to these problems.

show abstract

Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Pflüger

Bolierakis

Wurm

et al. 2021

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose Effective therapy of periprosthetic femur fractures of the hip (PPF) are challenging due to patients’ frailty and complexity of fracture patterns. The aim of this cohort study was to analyze the radiological and functional outcome following PPF. Methods A retrospective, multicenter study in the period 2009–2019 of patients with PPF at two level I trauma centers in Germany was performed. PPF were classified according to the Vancouver classification system. Demographic data, American Society of Anesthesiologists (ASA) classification, type of surgery, complications, and reoperation rate were obtained from patient records. The functional outcome was assessed by the modified Harris-Hip Score (mHHS), general health using the EQ-5D, and radiological outcome by Beals & Tower (B&T) criteria. Results A total of 129 patients with a mean age of 79 years (range 43–102) were included. 70% of all patients were female and 68% of the patients had an ASA score ≥ 3. 20 patients suffered from a Vancouver A, 90 from a Vancouver B and 19 from a Vancouver C fracture. 14% of the patients died within the first 2 years after surgery. The reoperation rate after open reduction and internal fixation (ORIF) (n = 60) was 8% and after revision arthroplasty (RA) (n = 47) 30% (OR 3.4, 95% CI [1.21–10.2]). Mean mHHS (n = 32) was 53 ± 19.4 and EQ-VAS was 50 ± 24.6. According to B&T criteria, 82% of patients treated with ORIF (n = 17) and 62% after RA (n = 13) showed an excellent outcome. Conclusion Patients with a PPF of the hip are elderly and at increased operative risk. In cases with a stable prosthesis, ORIF provides good radiological outcome with low reoperation rates. In case of RA, the risk for revision surgery is higher.

show abstract

Locking compression plate versus revision-prosthesis for Vancouver type B2 periprosthetic femoral fractures after total hip arthroplasty

Cited by 51 publications

References 19 publications

Fracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review

Fracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review

Case report: A 10 years follow-up of periprosthetic femoral fracture after total hip arthroplasty in osteopetrosis

Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Contact Info

Product

Resources

About