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Hip revision arthroplasty for failed osteosynthesis in periprosthetic Vancouver type B1 fractures using a cementless, modular, tapered revision stem.

Abstract To evaluate the hypothesis that failed osteosynthesis of periprosthetic Vancouver type B1 fractures can be treated successfully with stem revision using a transfemoral approach and a cementless, modular, tapered revision stem with reproducible rates of fracture healing, stability of the revision stem, and clinically good results.
PMID
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Authors

Mayor MeshTerms

Hip Prosthesis

Keywords

Failed osteosynthesis

Hip

Periprosthetic fracture

Revision arthroplasty

Vancouver type B1

Journal Title the bone & joint journal
Publication Year Start




PMID- 28363889
OWN - NLM
STAT- MEDLINE
DA  - 20170401
DCOM- 20170412
LR  - 20170412
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 99-B
IP  - 4 Supple B
DP  - 2017 Apr
TI  - Hip revision arthroplasty for failed osteosynthesis in periprosthetic Vancouver
      type B1 fractures using a cementless, modular, tapered revision stem.
PG  - 11-16
LID - 10.1302/0301-620X.99B4.BJJ-2016-1201.R1 [doi]
AB  - AIMS: To evaluate the hypothesis that failed osteosynthesis of periprosthetic
      Vancouver type B1 fractures can be treated successfully with stem revision using 
      a transfemoral approach and a cementless, modular, tapered revision stem with
      reproducible rates of fracture healing, stability of the revision stem, and
      clinically good results. PATIENTS AND METHODS: A total of 14 patients (11 women, 
      three men) with a mean age of 72.4 years (65 to 90) undergoing revision hip
      arthroplasty after failed osteosynthesis of periprosthetic fractures of Vancouver
      type B1 were treated using a transfemoral approach to remove the well-fixed stem 
      before insertion of a modular, fluted titanium stem which obtained distal
      fixation. These patients were clinically and radiologically followed up for a
      mean 52.2 months (24 to 144). RESULTS: After a mean of 15.5 weeks (standard
      deviation (sd) 5.7) all fractures had healed. No stems subsided and bony-ingrowth
      fixation had occurred according to the classification of Engh et al. The mean
      Harris Hip Score increased from a pre-operative score of 22.2 points (sd 9.7) to 
      81.5 points (sd 16.8) 24 months post-operatively. All hips had obtained an
      excellent result according to the classification of Beals and Tower. CONCLUSIONS:
      The technique described here for stem revision provides reproducibly good results
      in the treatment of failed osteosynthesis for Vancouver types B1 periprosthetic
      fractures of the hip. Cite this article: Bone Joint J 2017;99-B(4 Supple
      B):11-16.
CI  - (c)2017 Fink et al.
FAU - Fink, B
AU  - Fink B
AD  - University-Hospital Hamburg-Eppendort, Martinistrasse 52, 20246 Hamburg, Germany.
FAU - Oremek, D
AU  - Oremek D
AD  - Orthopaedic Clinic Markgroningen gGmbH, Kurt-Lindemann-Weg 10, 71706
      Markgroningen, Germany.
LA  - eng
PT  - Evaluation Studies
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
RN  - 0 (Bone Cements)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthroplasty, Replacement, Hip/*methods
MH  - Bone Cements
MH  - Female
MH  - Femoral Fractures/diagnostic imaging/*surgery
MH  - Follow-Up Studies
MH  - Fracture Fixation, Internal/*adverse effects/methods
MH  - Fracture Healing
MH  - *Hip Prosthesis
MH  - Humans
MH  - Male
MH  - Periprosthetic Fractures/diagnostic imaging/*surgery
MH  - Prosthesis Design
MH  - Prosthesis Failure
MH  - Radiography
MH  - Reoperation/methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Failed osteosynthesis
OT  - *Hip
OT  - *Periprosthetic fracture
OT  - *Revision arthroplasty
OT  - *Vancouver type B1
EDAT- 2017/04/02 06:00
MHDA- 2017/04/13 06:00
CRDT- 2017/04/02 06:00
PHST- 2016/11/21 [received]
PHST- 2016/12/20 [accepted]
AID - 99-B/4_Supple_B/11 [pii]
AID - 10.1302/0301-620X.99B4.BJJ-2016-1201.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2017 Apr;99-B(4 Supple B):11-16. doi:
      10.1302/0301-620X.99B4.BJJ-2016-1201.R1.

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