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Archives of Orthopaedic and Trauma Surgery

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01-06-2022 | Femoral Fracture | Trauma Surgery

Comparable outcomes of in-cement revision and uncemented modular stem revision for Vancouver B2 periprosthetic femoral fracture at 5 years

Authors: Antonio Klasan, James Millar, Jonathan Quayle, Bill Farrington, Peter Nicholas Misur

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2022

Abstract

Introduction

Periprosthetic femoral fractures (PFF) are detrimental for patients. Vancouver B2 fractures about a cemented stem can be revised to a longer uncemented stem or using an in-cement revision, if the cement mantle is adequate. There are reports documenting the success of both techniques. The aim of this single centre study was to perform a direct comparison of these two procedures.

Materials and methods

A retrospective study of consecutive Vancouver B2 PFFs around a cemented stem during 16 years was performed. All study cases were treated either using an in-cement revision or with an uncemented stem revision. Preoperatively, the groups were compared based upon age, gender, ASA, BMI, and Charlson comorbidity score. The outcome measures were surgical time, complications, in-hospital stay, revisions, 1-year readmission rate, and survivorship.

Results

After a median of 3.5 years, there were 70 patients in the uncemented and 31 in the in-cement group. There was no difference in any of the preoperative variables. Surgical time was shorter for in-cement revisions by a mean of 45 min (p < 0.001). There was no difference in in-hospital stay, surgical complications or readmissions. Implant survival at 5 years was 93.5% for the in-cement and 94.4% for the uncemented revision (p = 0.946). Patient survivorship at 5 years was 62.5% for the in-cement and 69.8% for the uncemented group (p = 0.094).

Conclusions

This study demonstrates that in-cement revision is a valid treatment option for Vancouver B2 fractures, comparable to uncemented stem revision, if certain criteria are met. There was no difference in revision rate, patient survivorship, complications, readmissions or in-hospital stay.

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Title: Comparable outcomes of in-cement revision and uncemented modular stem revision for Vancouver B2 periprosthetic femoral fracture at 5 years
Authors: Antonio Klasan
James Millar
Jonathan Quayle
Bill Farrington
Peter Nicholas Misur
Publication date: 01-06-2022
Publisher: Springer Berlin Heidelberg
Keyword: Femoral Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03776-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparable outcomes of in-cement revision and uncemented modular stem revision for Vancouver B2 periprosthetic femoral fracture at 5 years

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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