Surgical and functional outcomes of vancouver type B2 postoperative periprosthetic femoral fracture treated with revision arthroplasty and coxa femoral bypass

Authors

  • Shivaraj Amruthrao Chatrashali Department of Orthopaedics, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India
  • Rakshith Amaresh Gaddi Department of Orthopaedics, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242402

Keywords:

Hemiarthroplasty, Periprosthetic fracture, Revision arthroplasty, Total hip replacement

Abstract

As the number of total hip arthroplasties have steadily increased, one would expect a concomitant increase in catastrophic postoperative events such as periprosthetic fractures. This study evaluates the surgical and functional outcome, along with the associated complication rates in patients undergoing revision arthroplasty following Vancouver type B2 post-operative periprosthetic femoral fracture. We studied 14 Clinically and radiologically diagnosed patients with Vancouver type B2 Post-operative Periprosthetic femoral fracture.  The post-operative VAS score has decreased to 2.23±0.92 from a pre-operative score of 8.30±0.9, p<0.001. The average Harris Hip Score has improved from 44.05±7.71 pre-operatively to 83.63±7.75 post-operatively at 6 months, p<0.001. At 6-month follow-up, we had 57% excellent results, 29% good results, 7% fair results, and 7% poor results based on Harris Hip Score. The revision arthroplasty of Vancouver type B2 post-operative periprosthetic femoral fracture with revision arthroplasty and coxa femoral bypass has excellent-good surgical as well as functional outcomes in terms of regaining abductor function by an increase in range of motion at the affected hip joint, significant pain relief leading to improved quality of life after surgery at short term follow up period.

References

Evans JT, Evans JP, Walker RW, Blom AW. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. The Lancet. 2019;393(10172):647-54.

Berry DJ. Epidemiology: Hip and knee. Orthop Clin North Am. 1999;30(2):183-90.

Meek RM, Norwood T, Smith R. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br. 2011;93(1):96-101.

Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978–1990. Acta Orthop Scand. 1993;64(5):497-506.

Malchau H, Herberts P, Eisler T. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am. 2002;84(2):2-20.

Franklin J, Malchau H. Risk factors for periprosthetic femoral fracture. Injury. 2007;38(6):655-60.

Duncan CP, Masri BA. Fractures of the femur after hip replacement. Instr Course Lect. 1995;44:293-304.

Brady OH, Garbuz DS, Masri BA, Duncan CP. Classification of the hip. Orthop Clin North Am. 1999;30(2):215-20.

Medagam NR, Reddy B. Study of effectiveness of coxafemoral bypass in comparison to proximal femoral nail in the treatment of unstable intertrochanteric fractures in the elderly. J Orthop Traumatol Rehabil. 2008;10:19-22.

Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury. 2007;38:651-4.

Katz JN, Wright EA, Polaris JJZ, Harris MB, Losina E. Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskelet Disord. 2014;15:168.

Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty. 2005;20:857-65.

Ricci WM, Haidukewych GJ. Periprosthetic femoral fractures. Instr Course Lect. 2009;58:105-15.

Lindahl H, Malchau H, Herberts P, et al. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty 2005;20:857-65.

Katzer A, Ince A, Wodtke J. Component exchange in treatment of periprosthetic femoral fractures. J Arthroplasty. 2006;21:572-9.

Langenhan R, Trobisch P, Ricart P. Aggressive surgical treatment of periprosthetic femur fractures can reduce mortality: comparison of open reduction and internal fixation versus a modular prosthesis nail. J Orthop Trauma. 2012;26:80-5.

Ricci WM. Periprosthetic femur fractures. J Orthop Trauma. 2015;29:130-7.

Bhattacharyya T, Chang D, Meigs JB. Mortality after periprosthetic fracture of the femur. J Bone Joint Surg Am. 2007;89:2658-62.

Moreta J, Aguirre U, de Ugarte OS. Functional and radiological outcome of periprosthetic femoral fractures after hip arthroplasty. Injury. 2015;46:292-8.

Solomon LB, Hussenbocus SM, Carbone TA, Callary SA, Howie DW. Is internal fixation alone advantageous in selected B2 periprosthetic fractures? ANZ J Surg. 2015;85:169-73.

Joestl J, Hofbauer M, Lang N, Tiefenboeck T, Hajdu S. Locking compression plate versus revision-prosthesis for Vancouver type B2 periprosthetic femoral fractures after total hip arthroplasty. Injury. 2016;47:939-43.

Gitajn IL, Heng M, Weaver MJ, Casemyr N, May C, Vrahas MS, et al. Mortality following surgical management of vancouver b periprosthetic fractures. J. Orthop. Trauma. 2017;31:9-14.

Zuurmond, RG, Wijhe W, Raay JJ, Bulstra SK. High incidence of complications and poor clinical outcome in the operative treatment of periprosthetic femoral fractures: An analysis of 71 cases. Injury. 2010;41:629-33.

Füchtmeier B, Galler M, Müller F. Mid-term results of 121 periprosthetic femoral fractures: increased failure and mortality within but not after one postoperative year. J Arthroplast. 2015;30:669-74.

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Published

2024-08-28