Mid-term outcomes following transfemoral revision of total hip arthroplasty for Vancouver B2/B3 periprosthetic fractures |
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| Institution: | 1. Senior Resident, Department of Orthopaedics, PGIMER, Chandigarh, INDIA;2. Professor, Department of Orthopaedics, PGIMER, Chandigarh, INDIA;3. Assistant Professor, Department of Orthopaedics, PGIMER, Chandigarh, INDIA;4. Professor, Department of Radiodiagnosis, PGIMER, Chandigarh, INDIA;1. Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, Shanghai, 200233, China;2. Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200233, China;3. Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, Shanghai, 200233, China;4. Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science, Shanghai, 200063, China |
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| Abstract: | IntroductionPeriprosthetic femoral fractures (PFF) are often the reason for revising total hip arthroplasty (RTHA). Converting these fractures into modified extended trochanteric osteotomy (mETO) facilitates stem revision. Modular revision stems are a common choice with good results. We present mid-term outcomes in patients undergoing RTHA for Vancouver B2/B3 PFF using a tapered, fluted modular stem with an mETO approach.Materials and methodsA single-center analysis of patients with RTHA for Vancouver B2/B3 PFF using a single modular implant with mETO was performed (2007 – 2019). Clinical outcome (mobility, range of motion, function), radiological outcome (fracture healing, stem subsidence) and patient reported outcome measures (FJS-12, HHS, EQ-5D) were assessed.ResultsNinety-seven patients (mean age 78.1 years, BMI 25.8 kg/m2, 85.6% B2-fractures) were included; 80 patients had complete clinical and radiological follow-ups. Normal unaided gait without limping was achieved in 38/80 patients. After one year fracture / mETO healing occurred in 74/80 patients; 5.3 years after surgery, the respective FJS-12, HHS and EQ-5D (available in 34 patients) averaged 81.3 ± 30.2, 71.4 ± 18.7 and 0.8 ± 0.2. We documented 7 in-hospital deaths, 18.8% postoperative complications and 13.8% revisions with stem revisions being most commonly for subsequent PFF or subsidence.ConclusionGood clinical and radiological outcomes and rather low complication and revision rates (18.8% and 13.8%) were achieved. FJS-12 showed excellent results in patients undergoing RTHA for Vancouver B2/B3 PFF using a cementless, dual modular titanium revision stem and an mETO approach. Joint awareness was thereby similar to previously reported primary THA results at 5.3 years follow-up. |
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