Outcomes of Fixation of Vancouver B Periprosthetic Fractures Around Cemented Versus Uncemented Stems

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2023 Apr 4

PMID 37016368

Authors

Ameen Barghi

Philip Hanna

Nelson Merchan

Michael J Weaver

John Wixted

Paul Appleton

Edward Rodriguez

Affiliations

Soon will be listed here.

Abstract

Background: The incidence of periprosthetic femur fracture (PPFF) in the setting of total hip arthroplasty (THA) is steadily increasing. We seek to address whether there is a difference in outcomes between Vancouver B fracture types managed with ORIF when the original stem was a press-fit stem versus a cemented stem.

Methods: In this retrospective cohort study at a level 1 trauma center, we identified 136 patients over 65 years-of-age with Vancouver B-type fractures sustained between 2005 and 2019. Patients were treated by ORIF and had either cemented or press-fit stems prior to their injury. Outcomes were subsidence of the femoral implant, time to full weight bearing, rate of the hip implant revision, estimated blood loss (EBL), postoperative complications, and the one-year mortality rate.

Results: A total of 103 (75.7%) press-fit and 33 (24.3%) cemented patients were reviewed. Patient baseline characteristics, Vancouver fracture sub-types, and implant characteristics were not found to be significantly different between groups. The difference in subsidence rates, postoperative complications, and time to weight bearing were not significantly different between groups. EBL and one-year mortality rate were significantly higher in the cemented group.

Conclusions: In geriatric patients with Vancouver B type periprosthetic fractures managed with ORIF, patients with an originally press fit stem may have lower mortality, lower estimated blood loss, and similar subsidence and hospital length of stays when compared to those with a cemented stem.

Citing Articles

Exploring Individualized Approaches to Managing Vancouver B Periprosthetic Femoral Fractures: Insights from a Comprehensive Case Series Analysis.

Cursaru A, Popa M, Cretu B, Iordache S, Iacobescu G, Spiridonica R Cureus. 2024; 16(1):e53269.

PMID: 38435949 PMC: 10905061. DOI: 10.7759/cureus.53269.

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