Periprosthetic femoral fractures around the original cemented polished triple-tapered C-stem femoral implant: a consecutive series of 500 primary total hip arthroplasties with an average follow-up of 15 years

Abstract

Introduction The true incidence of periprosthetic femoral fracture (PFF) around cemented polished taper-slip implants remains largely unknown. Registries usually only capture PFFs that result in revision, missing those managed non-operatively or treated by open reduction and internal fixation (ORIF). This study reports the long-term rate of PFF with the original triple-tapered C-stem femoral implant. Materials and methods A prospective review of a consecutive series of 500 primary total hip arthroplasties (THAs) performed at a single centre between March 2000 and December 2005, with average follow-up of 15 years (12–19 years). Results There were 500 consecutive THAs in 455 patients. Seven PFFs (1.4%) occurred in seven patients at an average of 7.9 years (range 2–11.5) from the primary arthroplasty. Five PFFs were managed by ORIF, one Vancouver B3 fracture was revised for a loose implant and one patient was treated non-operatively. Average age at primary operation was 74 years (67–87) and BMI averaged 27.3 (22–31). There was no typical fracture pattern and no statistically significant associations with patient demographics (age, gender, BMI, diagnosis) or prosthetic details (size, offset, alignment, cement mantle, subsidence). Survivorship to the occurrence of PFF was 99% (97.3–99.6%) at 10 years and 97.8% (95.5–99.0%) at 15. Conclusion A PFF rate of 1.4% at an average follow-up of 15 years represents the true incidence of PFF with the use of the original triple-tapered C-Stem femoral implant, similar to that of published Exeter series (1.85%) but lower than the CPT (3.3%).

Exploring Individualized Approaches to Managing Vancouver B Periprosthetic Femoral Fractures: Insights from a Comprehensive Case Series Analysis

“…The field of total hip arthroplasty (THA) is undergoing rapid transformation due to several factors, including the increasing age of the population, advancements in surgical methodologies, and the emergence of novel implant materials. Nevertheless, this advancement is not without its own set of obstacles, primarily the rising prevalence of periprosthetic femoral fractures (PFFs) [1,2]. Fractures, whether they occur during surgery or after surgery, impose a considerable clinical burden, frequently resulting in unfavorable outcomes, elevated reoperation rates, and heightened mortality.…”

“…The objective of this article is to explore the intricacies surrounding PFFs, encompassing their epidemiology and classification systems, as well as the most recent treatment approaches and risk factors. By doing so, this article provides healthcare professionals with a comprehensive resource for effectively managing this complex complication [1,3].…”