Abstract
Purpose
Periprosthetic fractures are the fourth most common cause for hip revision and a devastating complication. Our purpose is to report results and quality of life following revision THA for Vancouver B2 and B3 fractures.
Methods
This was a retrospective review from January 2000 to November 2012 to identify all revision THA performed for Vancouver types B2 and B3 that had a minimum follow-up of two years. Routine post-operative and radiographic evaluation to assess patient survival, implant failure, complications and quality of life was involved. Statistical analysis was made with the Kaplan-Meier survival curve with 95 % confidence interval and the log rank (Mantel-Cox) test.
Results
A total of 76 fractures were included, with an average follow-up 74.4 months. Mean age at the revision surgery was 75.7 years (range, 41–97 years; SD, 12.4). Sixty-six cases were classified as Vancouver B2 and treated with distal fixation stem. Ten cases were Vancouver B3 and a proximal femoral allograft technique was used. The overall five-year Kaplan-Meier survival rate for the patients was 77.9 % (95 % CI, 67.4–88.4), and the ten-year rate was 65.1 % (95 % CI, 51.4–78.8). Five-year Kaplan-Meier survival rate for the implants was 89.6 % (95 % CI, 82.2–97); we presented seven failures. The mean SF-12 mental was 55.1 (range, 31–68; SD, 8.1) and the physical was 37.4 (range, 16–55; SD, 9.4).
Conclusion
Mortality rate after periprosthetic fractures is high as compared to other hip surgeries; our Kaplan-Meier analysis showed that it tends to plateau after five years. In our series the failure rate was low and occurred early in the post-operative period.
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Amenabar, T., Rahman, W.A., Avhad, V.V. et al. Vancouver type B2 and B3 periprosthetic fractures treated with revision total hip arthroplasty. International Orthopaedics (SICOT) 39, 1927–1932 (2015). https://doi.org/10.1007/s00264-015-2957-6
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DOI: https://doi.org/10.1007/s00264-015-2957-6