Management of Vancouver type B2 and B3 femoral periprosthetic fractures using an uncemented extensively porous-coated long femoral stem prosthesis

Objective

The purpose of this study was to evaluate the clinical results of femoral revision using an uncemented extensively porous-coated long femoral stems with or without onlay strut allografts in the treatment of Vancouver type B2 and B3 periprosthetic femoral fractures.

Materials and methods

We retrospectively reviewed 17 cases of periprosthetic femoral fracture (eight B2 and nine B3) treated with the uncemented extensively porous-coated long femoral stem. Clinical outcomes were assessed with Harris Hip Score and Barthel ADL index. Radiological evaluations were conducted using Beals and Towers’ criteria. Any complication during the follow-up period was recorded.

Results

The average follow-up period was 41.7 ± 31.08 (range, 15–132) months. The average Harris Hip Score was 68.2 ± 18.4 (range, 32–100), and the average Barthel ADL index was 80.1 ± 19.75 (range, 30–100) points at the final follow-up. All fractures were united, and a good graft consolidation was achieved in 5 of 9 cases. There was femoral stem subsidence in 4 cases less than 10 mm without an evidence of loosening both radiologically and clinically. The radiological results using Beals and Towers’ criteria were excellent in eight hips, good in five and poor in four.

Conclusions

An uncemented extensively porous-coated long femoral stem together with or without onlay strut allografts provides a good fracture stability that promotes fracture healing and offers a successful solution for the management of Vancouver type B2 and B3 femoral periprosthetic fractures.