Skip to main content
SpringerLink
Log in

Periprosthetic Fractures of the Femur After Hip Arthroplasty: An Analysis of 99 Patients

  • Original Article
  • Published:
HSS Journal

Abstract

The medical records and radiographs of 99 patients treated for a periprosthetic femur fracture after total hip arthroplasty over a 17-year period at a single institution were prospectively reviewed. Fractures were classified according to the Vancouver system and stratified as to treatment method. Sixty-six patients had complete records available and a minimum of 12 months follow-up. Overall, 86% of the patients achieved fracture union. The success rate of cemented revision in the B2 and B3 groups was 84%, whereas cement-less revision was 86% successful. The complication rate of surgical treatment was 29%. Fracture union with a stable implant was possible in the majority of cases. Our results support the use of the Vancouver classification as a treatment algorithm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Beals RK, Tower SS (1996) Periprosthetic fractures of the femur. An analysis of 93 fractures. Clin Orthop 327:238–246

    Article  PubMed  Google Scholar 

  2. Sledge JB, Abiri A (2002) An algorithm for the treatment of Vancouver type B2 periprosthetic proximal femoral fractures. J Arthroplasty 17:887–892

    Article  PubMed  Google Scholar 

  3. Ahuja S, Chatterji S (2002) The Mennen femoral plate for fixation of periprosthetic femoral fractures following hip arthroplasty. Injury 33(1):47–50

    Article  PubMed  Google Scholar 

  4. Brady OH, Garbuz DS, Masri BA, Duncan CP (1999) The treatment of periprosthetic fractures of the femur using cortical onlay allograft struts. Orthop Clin North Am 30(2):249–257

    Article  PubMed  CAS  Google Scholar 

  5. Eingartner C, Volkmann R, Putz M, Weller S (1997) Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures. Int Orthop 21(1):25–29

    Article  PubMed  CAS  Google Scholar 

  6. Lewallen DG, Berry DJ (1998) Periprosthetic fracture of the femur after total hip arthroplasty: treatment and results to date. Instr Course Lect 47:243–249

    PubMed  CAS  Google Scholar 

  7. Tadross TS, Nanu AM, Buchanan MJ, Checketts RG (2000) Dall-Miles plating for periprosthetic B1 fractures of the femur. J Arthroplasty 15(1):47–51

    Article  PubMed  CAS  Google Scholar 

  8. Venu KM, Koka R, Garikipati R, Shenava Y, Madhu TS (2001) Dall-Miles cable and plate fixation for the treatment of peri-prosthetic femoral fractures—analysis of results in 13 cases. Injury 32(5):395–400

    Article  PubMed  CAS  Google Scholar 

  9. Schmidt AH, Kyle RF (2002) Periprosthetic fractures of the femur. Orthop Clin North Am 33(1):143–152

    Article  PubMed  Google Scholar 

  10. Nelson CL (2002) Periprosthetic fractures of the femur following hip arthroplasty. Am J Orthop 31(4):221–223

    PubMed  Google Scholar 

  11. Springer BD, Berry DJ, Lewallen DG (2003) Treatment of periprosthetic femoral fractures following total hip arthroplasty with femoral component revision. J Bone Joint Surg Am 85-A(11):2156–2162

    PubMed  Google Scholar 

  12. Ko PS, Lam JJ, Tio MK, Lee OB, Ip FK (2003) Distal fixation with Wagner revision stem in treating Vancouver type B2 periprosthetic femur fractures in geriatric patients. J Arthroplasty 18(4):446–452

    Article  PubMed  CAS  Google Scholar 

  13. Berry DJ (2003) Treatment of Vancouver B3 periprosthetic femur fractures with a fluted tapered stem. Clin Orthop 417:224–231

    PubMed  Google Scholar 

  14. Berry DJ (2002) Management of periprosthetic fractures: the hip. J Arthroplasty 17(4 Suppl 1):11–13

    Article  PubMed  Google Scholar 

  15. Clift B (2000) Periprosthetic fracture of the femur. J Bone Joint Surg Am 82(3):446–447

    PubMed  Google Scholar 

  16. Berry DJ (1999) Epidemiology: hip and knee. Orthop Clin North Am 30(2):183–190

    Article  PubMed  CAS  Google Scholar 

  17. Duncan CP, Masri BA (1995) Fractures of the femur after hip replacement. Instr Course Lect 44:293–304

    PubMed  CAS  Google Scholar 

  18. Brady OH, Garbuz DS, Masri BA, Duncan CP (1999) Classification of the hip. Orthop Clin North Am 30(2):215–220

    Article  PubMed  CAS  Google Scholar 

  19. Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop 257:107–128

    PubMed  Google Scholar 

  20. Harris WH, McCarthy JC, O’Neill DA (1982) Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 64(7):1063–1067

    PubMed  CAS  Google Scholar 

  21. Abendschein W (2003) Periprosthetic femur fractures—a growing epidemic. Am J Orthop 32(9):34–36 (Suppl)

    PubMed  Google Scholar 

  22. Berry DJ (2003) Periprosthetic fractures associated with osteolysis: a problem on the rise. J Arthroplasty 18(3 Suppl 1):107–111

    Article  PubMed  Google Scholar 

  23. Wang JW, Wang CJ (2000) Periprosthetic fracture of the femur after hip arthroplasty: the clinical outcome using cortical strut allografts. J Orthop Surg (Hong Kong) 8(1):27–31

    CAS  Google Scholar 

  24. Cook SD, Barrack RL, Santman M, Patron LP, Salkeld SL, Whitecloud TS 3rd (2000) The Otto Aufranc Award. Strut allograft healing to the femur with recombinant human osteogenic protein-1. Clin Orthop 381:47–57

    Google Scholar 

  25. Porsch M, Galm R, Hovy L, Starker M, Kerschbaumer F (1996) Total femur replacement following multiple periprosthetic fractures between ipsilateral hip and knee replacement in chronic rheumatoid arthritis. Case report of 2 patients. Z Orthop Ihre Grenzgeb 134(1):16–20

    Article  PubMed  CAS  Google Scholar 

  26. Mont MA, Maar DC (1994) Fractures of the ipsilateral femur after hip arthroplasty. A statistical analysis of outcome based on 487 patients. J Arthroplasty 9(5):511–519

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Naval Medical Center San Diego Department of Orthopaedic Surgery, San Diego, CA, USA

    Keith Holley MD

  2. Hospital for Special Surgery, Cornell University Medical Center, 535 E 70th St, New York, NY, 10021, USA

    Jonathan Zelken BA, Douglas Padgett MD & Robert Buly MD

  3. Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA, 70121, USA

    George Chimento MD

  4. The Arthritis Institute, John F. Kennedy Hospital, Dr Carreon Blvd, Indio, CA, 92201, USA

    Andrew Yun MD

Authors
  1. Keith Holley MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jonathan Zelken BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Douglas Padgett MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. George Chimento MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrew Yun MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert Buly MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Buly MD.

Additional information

No institutional or private financial support was available for this study. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, the Department of Defense, or the United States Government.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Holley, K., Zelken, J., Padgett, D. et al. Periprosthetic Fractures of the Femur After Hip Arthroplasty: An Analysis of 99 Patients. HSS Jrnl 3, 190–197 (2007). https://doi.org/10.1007/s11420-007-9045-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-007-9045-4

Key words

Search

Navigation