Uncemented Revision Hip Arthroplasty in B2 and B3 Periprosthetic Femoral Fractures - A Prospective Analysis

Abstract

Periprosthetic femoral fractures are an increasingly common complication of total hip arthroplasty. If there is a fracture of the femur in the presence of an unstable prosthesis (Vancouver type B2 and B3), revision of the stem is imperative. We describe our experience of cementless femoral revision in management of twenty-six patients who sustained periprosthetic fractures of the Vancouver type B2 or B3, between February 1999 and March 2005. All patients were managed by revision arthroplasty, using cementless femoral stems. Cortical struts, cable plating systems, bone allograft and demineralised bone matrix were used to aid the reconstruction where indicated. All the fractures had clinical and radiological union. The outcome was graded, subjectively as satisfactory by all patients and this is substantiated objectively, by a post operative mean Harris hip score of 83.04. Uncemented revision appears to be an attractive option for periprosthetic fractures with unstable femoral stems.