Hip Pelvis.  2016 Jun;28(2):90-97. 10.5371/hp.2016.28.2.90.

Could Patient Undergwent Surgical Treatment for Periprosthetic Femoral Fracture after Hip Arthroplasty Return to Their Status before Trauma?

• Zheng L
• Lee WY
• Hwang DS
• Kang C
• Noh CK

• KMID: 2328344
• DOI: http://doi.org/10.5371/hp.2016.28.2.90

Abstract

PURPOSE
The purpose of this study was to compare preoperative clinical outcomes before occurrence of periprosthetic femoral fracture (status before trauma) with postoperative clinical outcomes (status after operation) in patients with periprosthetic femoral fracture after hip arthroplasty.
MATERIALS AND METHODS
A retrospective review was performed of all periprosthetic femoral fracture after hip arthroplasty treated surgically at our institution from January 2010 to January 2014. Among 29 patients who underwent surgical treatment for periprosthetic femoral fracture after hip arthroplasty, 3 patients excluded because of non-union of the fracture site. The clinical outcomes were determined by using visual analogue scale for pain (VAS), Harris hip score (HHS), and ambulatory ability using Koval classification. VAS, HHS and ambulatory ability was assessed for all the included patients at the last follow-up of status before trauma and after operation.
RESULTS
The mean VAS, HHS and ambulatory ability at the last follow-up of status before trauma was 2.2 (range, 0-4), 78.9 (range, 48-92) and 1.9 (range, 1-5), respectively. The mean VAS, HHS and ambulatory ability at the last follow-up of status after operation was 3.1 (range, 1-5), 68.4 (range, 46-81) and 2.9 (range, 2-6), respectively. The clinical outcome of VAS, HHS and ambulatory ability were significantly worsened after surgical treatment for periprosthetic femoral fracture (P=0.010, P=0.001, and P=0.002, respectively).
CONCLUSION
Patients with periprosthetic femoral fracture after hip arthroplasty could not return to their status before trauma, although patients underwent appropriate surgical treatment and the fracture union achieved.

Keyword

Arthroplasty; Clinical outcome; Hip; Periprosthetic fractures

MeSH Terms

Arthroplasty*
Classification
Femoral Fractures*
Follow-Up Studies
Hip*
Humans
Periprosthetic Fractures
Retrospective Studies

Figure

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  Fig. 1 (A) A plain hip radiograph of a 72-year-old female with periprosthetic fracture following primary total hip arthroplasty because of avascular necrosis of femoral head shows type B1 of Vancouver classification. (B) She underwent open reduction and internal fixation with the cables.

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  Fig. 2 (A) A plain hip radiograph of a 72-year-old male with periprosthetic fracture following primary total hip arthroplasty because of avascular necrosis of femoral head shows type B1 of Vancouver classification. (B) He underwent open reduction and internal fixation with NCB periprosthetic femur plate (Zimmer, Warsaw, IN, USA) and the cables.

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  Fig. 3 (A) A plain hip radiograph of a 72-year-old male with periprosthetic fracture following primary bipolar hemiarthroplasty because of femoral neck fracture shows type B2 of Vancouver classification. (B) He underwent revision with U2 revision hip stem (United Orthopedic Corporation, Irvine, CA, USA) with the cables.

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  Fig. 4 (A) A plain hip radiograph of a 84-year-old female with periprosthetic fracture following primary hemiarthroplasty because of femoral neck fracture shows type C of Vancouver classification. (B) She underwent open reduction and internal fixation with Cable-ready bone plate (Zimmer, Warsaw, IN, USA) and the cables.

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