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Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

According to Vancouver classification, B2 type fractures are most often treated with removal of the loose stem and implantation of a long stem that bypasses the fracture site. However, there is a controversy about the stem fixation that should be used: cemented or cementless. Hence, this study aims to compare cemented and cementless stems in prosthetic revision due to Vancouver B2 (VB2) periprosthetic hip fracture.

Methods

A retrospective study was done including all the patients treated with stem exchange due to VB2 periprosthetic hip fracture in a tertiary hospital between 2015 and 2022. Patients were divided into two groups according to the stem fixation used: cemented or cementless. Functional outcomes, hospital stay, surgical time, complication rate, and mortality were compared between the two groups of patients.

Results

Of the 30 included patients, 13 (43.4%) were treated with cementless stems and 17 (56.7%) with cemented stems. There were no statistically significant differences in age, gender, anesthesia risk scale (ASA) or functional capacity prior to the intervention. Patients treated with cementless stems had a higher complication and reintervention rate than those treated with cemented stems: 62 and 45% versus 34 and 6% (p = 0.035; p = 0.010), respectively. Furthermore, in the group of cementless stems a higher proportion of non-union was found (53.8% vs. 17.6%; p = 0.037). Also, the hospital stay (33 vs. 24 days; p = 0.037) and the time to full weight-bearing (21 days vs. 9 days; p < 0.001) were longer in the cementless stem group.

Conclusion

Cemented fixation in stem revision due to Vancouver B2 periprosthetic hip fracture could be an optimal option with faster recovery which could decrease the rate of complications and reintervention, without compromising the fracture healing and patient mortality. Thus, this option can be considered when an anatomical reduction can be obtained, especially in elderly patients with multiple comorbidities in which a less aggressive surgical option should be considered.

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Funding

This research received no specific grant from any funding agency.

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Authors and Affiliations

  1. Hospital Universitari Vall d’Hebron, Pg. Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    Yuri Lara-Taranchenko, Josep F. Nomdedéu Jr., Andrés Aliaga Martínez, Iñaki Mimendia, Víctor M. Barro, Diego Collado, Ernesto Guerra-Farfán & Alejandro Hernández

Authors
  1. Yuri Lara-Taranchenko
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  2. Josep F. Nomdedéu Jr.
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  3. Andrés Aliaga Martínez
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  4. Iñaki Mimendia
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  5. Víctor M. Barro
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  6. Diego Collado
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  7. Ernesto Guerra-Farfán
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  8. Alejandro Hernández
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Correspondence to Yuri Lara-Taranchenko.

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The Author(s) declare that they have no conflict of interest.

Ethical approval

The ethical committee of the University Hospital Vall d’Hebron approved the study. PR(AT)624/2023.

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The anonymity of the patients was kept during the analysis, so informed consent was not required.

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Lara-Taranchenko, Y., Nomdedéu, J.F., Aliaga Martínez, A. et al. Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03961-3

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  • DOI: https://doi.org/10.1007/s00590-024-03961-3

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