Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017
Background Peripheral femoral fractures (PFFs) are a devastating complication after total hip arthroplasty (THA). The accepted treatment for the Vancouver B3 fracture is revision surgery. However, there is still no consensus on which bone grafting technique to treat the bone defect around the femoral prosthesis in revision surgery. Therefore, we designed a retrospective study to evaluate the efficacy of ICA (impacted cancellous allograft) and ICA+CSA (cortical strut allograft) in B3-type PFFs revision surgery using uncemented stems. Methods We retrospectively assessed 47 Vancouver-type B3 PFFs in 47patients who have been treated between 2000 and 2017. All patients underwent intraoperative bone grafting.18 patients treated with ICA and 29 patients treated with ICA+CSA. Functional outcomes were assessed using Harris hip score, SF-36 scores and complications. Radiological findings were classified using Engh standard. Kaplan–Meier survival curve was used to assess patient and implant survival. Results There were 18 males and 29 females with an average age of 62.5 ± 9.9 years. The average follow-up time was 63.5 months. 90.7% of patients achieved fracture healing and 17.0% received secondary revision surgery. The overall 5-year Kaplan–Meier survival rate for the patients was 64.7% (95% CI, 50.6-78.8), and the 10-year rate was 47.4% (95% CI, 30.4–64.5). The last evaluated mean SF-36 was 46.1; Harris hip scores were 44.6 (3 months), 61.7 (12 months); respectively. Conclusions The use of ICA and ICA+CSA to reconstruct bone stock can provide stable prosthesis support and satisfactory fracture healing rate.
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Posted 20 Jan, 2020
Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017
Posted 20 Jan, 2020
Background Peripheral femoral fractures (PFFs) are a devastating complication after total hip arthroplasty (THA). The accepted treatment for the Vancouver B3 fracture is revision surgery. However, there is still no consensus on which bone grafting technique to treat the bone defect around the femoral prosthesis in revision surgery. Therefore, we designed a retrospective study to evaluate the efficacy of ICA (impacted cancellous allograft) and ICA+CSA (cortical strut allograft) in B3-type PFFs revision surgery using uncemented stems. Methods We retrospectively assessed 47 Vancouver-type B3 PFFs in 47patients who have been treated between 2000 and 2017. All patients underwent intraoperative bone grafting.18 patients treated with ICA and 29 patients treated with ICA+CSA. Functional outcomes were assessed using Harris hip score, SF-36 scores and complications. Radiological findings were classified using Engh standard. Kaplan–Meier survival curve was used to assess patient and implant survival. Results There were 18 males and 29 females with an average age of 62.5 ± 9.9 years. The average follow-up time was 63.5 months. 90.7% of patients achieved fracture healing and 17.0% received secondary revision surgery. The overall 5-year Kaplan–Meier survival rate for the patients was 64.7% (95% CI, 50.6-78.8), and the 10-year rate was 47.4% (95% CI, 30.4–64.5). The last evaluated mean SF-36 was 46.1; Harris hip scores were 44.6 (3 months), 61.7 (12 months); respectively. Conclusions The use of ICA and ICA+CSA to reconstruct bone stock can provide stable prosthesis support and satisfactory fracture healing rate.
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