Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures

Eingartner, C.; Volkmann, R.; Putz, Maria; Weller, S.

doi:10.1007/s002640050112

Cited by 36 publications

(20 citation statements)

References 20 publications

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“…Despite different classification systems and treatment methods, the ideal solution for this entity has always been a dilemma [7]. In recent years great advances in prosthetic designs such as distal locking modular revision prosthesis, fixed angle locking plates, and usage of cortical onlay grafts have improved the outcomes of these fractures [6,11,18,19]. Our study examined the demography, patterns of fracture, treatment modalities and rate of failure in patients having operative treatment for postoperative periprosthetic fracture of femur.…”

Section: Discussionmentioning

confidence: 99%

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients

Mukundan

Rayan

Kheir

et al. 2009

International Orthopaedics (SICOT)

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We present our series of 72 patients with periprosthetic fractures. The Vancouver classification was used to evaluate the fractures; there was one type A, seven type B1, 42 type B2, 17 type B3 and five type C fractures. Demographics, pre and postoperative data using Charnley-D'Aubigne-Postel score for assessment of function were recorded. The mean follow-up for all patients was two years. The overall outcome of treatment was graded as excellent, good or poor. An excellent result indicated that the arthroplasty was stable with minimal deformity and no shortening. Stable subsidence of the prosthesis or when the fracture healed with moderate deformity or shortening was deemed as a good result. A loose prosthesis, nonunion, sepsis, severe deformity or shortening was considered poor. In our series 79% (n=57) had good or excellent results following surgical intervention and 21% (n=15) had complications; they all had undergone re-operation for various reasons such as nonunion, loosening, dislocation or infection. In B2 fractures the stem is unstable and hence revision of the prosthetic stem has been recommended with or without additional fixation. For B3 fractures an allograft prosthesis composite or tumour prosthesis is considered the treatment choice.

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Section: Discussionmentioning

confidence: 99%

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients

Mukundan

Rayan

Kheir

et al. 2009

International Orthopaedics (SICOT)

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“…The majority of the uncemented revision stems in the registry data (46/170, 86%) were of the extensively coated type. A further 3% (5/170) of the uncemented revision femoral components used distal interlocking screws, which have been advocated in the treatment of periprosthetic fractures (Clift 2000), although complications including screw breakage are common (Eingartner et al 1997).…”

Section: Discussionmentioning

confidence: 99%

Functional outcome of femoral peri prosthetic fracture and revision hip arthroplasty: A matched‐pair study from the New Zealand Registry

2008

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Background and purpose The number of periprosthetic fractures following total hip arthroplasty (THA) is increasing. There is, however, limited data on the functional outcome following these injuries. We analyzed functional outcome for revision THA following periprosthetic fracture, and compared this to the outcome of elective revision THA performed for aseptic loosening.Methods 232 patients undergoing revision THA for femoral fracture were identified from the New Zealand National Registry. Functional outcome was measured using the Oxford 12 hip score (OHS). A reference group of 232 patients undergoing elective revision THA was selected and matched for age and sex.Results Outcome was worse following revision THA for periprosthetic fracture than in reference patients (mean OHS: 29 vs. 24, p = 0.006). A higher 6-month mortality rate was seen in periprosthetic fracture patients (7.3% vs. 0.9%, p < 0.001), along with a higher likelihood of re-revision (7.3% vs. 2.6%, p = 0.06).Interpretation This large comparative series of periprosthetic fractures following THA shows that patients with periprosthetic fracture have poorer functional outcome and higher death rates than patients undergoing revision THA for aseptic loosening.

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“…The results of management of periprosthetic fractures have varied greatly due to factors such as bone quality, fracture pattern and method of treatment including nonoperative measures, reduction-fixation, or revision surgery. These treatments have historically been fraught with a high incidence of complications, treatment failures, and compromised outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13]. Despite these problems, surgical treatment has become the standard in treating the majority of periprosthetic femur fracture [14].…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic Fractures of the Femur after Hip Arthroplasty: An Analysis of 99 Patients

Holley

Zelken

Padgett

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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The medical records and radiographs of 99 patients treated for a periprosthetic femur fracture after total hip arthroplasty over a 17-year period at a single institution were prospectively reviewed. Fractures were classified according to the Vancouver system and stratified as to treatment method. Sixty-six patients had complete records available and a minimum of 12 months follow-up. Overall, 86% of the patients achieved fracture union. The success rate of cemented revision in the B2 and B3 groups was 84%, whereas cement-less revision was 86% successful. The complication rate of surgical treatment was 29%. Fracture union with a stable implant was possible in the majority of cases. Our results support the use of the Vancouver classification as a treatment algorithm.

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Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures

Cited by 36 publications

References 20 publications

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients

Functional outcome of femoral peri prosthetic fracture and revision hip arthroplasty: A matched‐pair study from the New Zealand Registry

Periprosthetic Fractures of the Femur after Hip Arthroplasty: An Analysis of 99 Patients

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