Abstract
Purpose
The number of patients having hip and knee arthroplasties on the ipsilateral leg is going to rise. In this regard, the prevalence of interprosthetic femoral fractures is going to increase further. The treatment of these fractures is difficult and sometimes it is impossible to perform an osteosynthesis because of worse bone quality. The goal of this study was to investigate the use of an interposition sleeve as an alternative treatment option for interprosthetic fractures with major bone loss.
Methods
Six human cadaveric femurs were instrumented using cemented hip- and knee prosthesis. Interprosthetic fractures were induced during a four-point-bending test and then treated using the interposition sleeve. Afterwards the constructs were tested using the four-point-bending test again.
Results
Load-to-failure of the construct before fracturing was significantly higher than after treatment with the interposition sleeve (10681 N vs. 5083 N; p = 0.002). The failure mechanism of the femurs with the interposition sleeve was plastic deformation of the hip or knee prosthesis. The interposition sleeve did not fail in any specimen.
Conclusion
The interposition sleeve is a valuable treatment option for interprosthetic fractures in situations in which osteosynthesis is impossible or insecure due to major bone defects. However, fracture healing should be preferred whenever possible.
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Acknowledgments
Funding from the state of Hamburg is kindly acknowledged. The authors would also like to thank Link, Hamburg, Germany for supporting the study with implants as well as the Stiftung Endoprothetik for financial support.
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I (we) certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
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Weiser, L., Korecki, M.A., Sellenschloh, K. et al. Interposition sleeve as treatment option for interprosthetic fractures of the femur: a biomechanical in vitro assessment. International Orthopaedics (SICOT) 39, 1743–1747 (2015). https://doi.org/10.1007/s00264-015-2788-5
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DOI: https://doi.org/10.1007/s00264-015-2788-5