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Periprosthetic Femur Fractures Treated With Modular Fluted, Tapered Stems

  • Symposium: 2013 Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Treatment of periprosthetic femur fractures is challenging, and high failure and complication rates have been reported in many series. The optimal techniques and implants for the management of Vancouver B2 and B3 fractures remain in debate.

Questions/purposes

The purpose of this study was to evaluate the results of a relatively new class of femoral implants, uncemented fluted, tapered, modular stems, to treat periprosthetic femur fractures; we specifically evaluated (1) fracture union; (2) implant stability; (3) patient outcomes; and (4) complications.

Methods

We retrospectively identified 44 Vancouver B2 (25 patients) and B3 (19 patients) periprosthetic femur fractures treated consecutively with fluted, tapered stems at a single institution from 2000 to 2006. The mean patient age was 72 years (range, 34–92 years), and 24 were women. The minimum followup was 2 years (mean, 4.5 years; range, 2–8 years).

Results

Forty-three of 44 (98%) fractures healed radiographically and 43 of 44 (98%) femoral components were stable radiographically at latest followup. The mean postoperative Harris hip score was 83. There were seven additional reoperations (five for recurrent instability, two for deep infections).

Conclusions

Modular fluted, tapered stems provide a reliable treatment method for Vancouver B2 and B3 periprosthetic femoral fractures with a high rate of fracture union and implant osteointegration. The most common complication, instability, may be reduced by more consistent use of larger femoral head diameters.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Fig. 1A–B
Fig. 2A–D

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Acknowledgments

We thank Youlonda A. Loechler for her assistance in data collection from the total joint database.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Matthew P. Abdel MD, David G. Lewallen MD & Daniel J. Berry MD

Authors
  1. Matthew P. Abdel MD
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  2. David G. Lewallen MD
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  3. Daniel J. Berry MD
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Corresponding author

Correspondence to Matthew P. Abdel MD.

Additional information

The institution of one or more of the authors (MPA, DGL, DJB) has received funding from DePuy (Warsaw, IN, USA), Zimmer (Warsaw, IN, USA), Stryker (Mahwah, NJ, USA), and Biomet (Warsaw, IN, USA). One author certifies that he (DJB), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount in excess of USD 100,000 from DePuy Orthopaedics, Inc, a Johnson and Johnson Company (Warsaw, IN, USA). Another author certifies that he (DGL), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount in excess of USD 100,000 from Zimmer, Inc (Warsaw, IN, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Abdel, M.P., Lewallen, D.G. & Berry, D.J. Periprosthetic Femur Fractures Treated With Modular Fluted, Tapered Stems. Clin Orthop Relat Res 472, 599–603 (2014). https://doi.org/10.1007/s11999-013-2936-4

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  • DOI: https://doi.org/10.1007/s11999-013-2936-4

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