Results of Treatment of Periprosthetic Femoral Fractures After Total Hip Arthroplasty

Abstract

Summary: Periprosthetic fractures are the third most common reason for revision total hip arthroplasty. Surgical treatment of periprosthetic fractures belongs to the most difficult procedures due to the extensive surgery, elderly polymorbid patients and the high frequency of other complications. The aim of this study was to evaluate the results of operatively treated periprosthetic femoral fractures after total hip arthroplasty. We evaluated 47 periprosthetic fractures in 40 patients (18 men and 22 women) operated on between January 2004 and December 2010. The mean follow-up period was 27 months (within a range of 12-45 months). For the clinical evaluation, we used modified Merle d'Aubigné scoring system. In group of Vancouver A fractures, 3 patients were treated with a mean score of 15.7 points (good result). We recorded a mean score of 14.2 points (fair result) in 6 patients with Vancouver B1 fractures, 12.4 points (fair result) in 24 patients with Vancouver B2 fractures and 12.7 points (fair result) in 7 patients with Vancouver B3 fractures. In group of Vancouver C fractures, we found a mean score of 16.2 points (good result) in 7 patients. Therapeutic algorithm based on the Vancouver classification system is, in our opinion, satisfactory. Accurate differentiation of B1 and B2 type of fractures is essential. Preoperative radiographic images may not be reliable. If in doubt, checking the stability of the prosthesis fixation during surgery should be performed.

The Outcomes of Total Hip Replacement in Patients with Parkinson’s Disease: Comparison of the Elective and Hip Fracture Groups

“…Falls in the period after total hip arthroplasty may result in serious periprosthetic fractures of the femur as is seen in 8.3% of hip joints in our study. Surgical treatment of periprosthetic fractures belongs to the most difficult orthopaedic procedures due to the extensive surgery with increased blood loss, high frequency of other complications, and series of unfavorable outcomes, such as disability and death [ 30 ].…”

Outcome of Periprosthetic Femoral Fractures in Hip Arthroplasty

“…Данные согласуются с мнением авторов, считающих, что неоперативное лечение перипротезных переломов часто приводит к неудовлетворительным результатам, а использование серкляжей не всегда обеспечивает достаточно стабильную фиксацию [21]. при использовании пластин могут возникать проблемы с цементной мантией вокруг имплантата во время проведения винтов [22]. В свою очередь, при несращении после первой попытки лечения перелома, в качестве которой было выбрано ревизионное эндопротезирование, повторное лечение привело к успешному исходу в 70% случаев.…”

“…предположительно неудовлетворительные результаты лечения пациентов с переломами типа B1 могут быть связаны с нарушением техники выполнения фиксации или недооценкой стабильности бедренного компонента при дифференциальной диагностике переломов типа B1 и B2 [19,21]. Использование предоперационных рентгенограмм может быть недостаточно надежным для оценки стабильности бедренного компонента имплантата, поэтому важно проводить дополнительную проверку стабильности ножки эндопротеза интраоперационно [21,22,26]. В.В.…”

Evaluating risk factors following surgery for periprosthetic fractures around hip and knee arthroplasties

“…It is the third-most common reason for hip or knee revision surgery [1][2][3]. A variety of classifications exist to try and assist with the diagnosis and management of these fractures, which have shown a good overall treatment outcome [4][5][6]. Examples of those classification systems include Vancouver [7], Su [8], Felix and Associates' Classification [9], and the Unified Classification system [10], which allow for a logical treatment choice.…”

“…Furthermore, the biomechanics of how an implant works are better understood and the design keeps evolving [1,5,[11][12][13][14]. This patient population is not dissimilar to the fracture neck of femur; however, the surgery is often much more complex and demanding, associating the PPF treatment with high morbidity and mortality [1,2,4,5,[11][12][13]15]. There is little reported evidence regarding patient survivorship following PPF treatment and mortality following fixation is poorly understood [1].…”