Mineta, Kazuaki Tokushima University
福田, 昇司 Kochi Health Science Center
Total hip arthroplasty
Periprosthetic femoral fractures with implant loosening are difficult to treat, especially when accompanied by severe bone loss.We report here the treatment outcomes of 4 patients (1 man, 3 women ; age range 69-86 years) with periprosthetic femoral fractures and implant loosening after bipolar hemiarthroplasty. Fractures were classified according to the Vancouver classification as type B2 and B3, with adequate or compromised bone stock, respectively. One patient was initially treated conservatively but symptoms due to implant loosening persisted and revision surgery was required. All patients underwent revision using a long-stem cementless implant with interlocking screws as well as a cancellous allograft to augment the bone stock. At final follow-up (mean, 25 months), all patients had stable implant fixation, bony union of the fracture, and marked recovery of the proximal femoral bone stock through allograft use. This revision procedure achieved implant fixation and fracture healing with reconstitution of the femur even in the short term and even in cases with severe bone deficiency.
The Journal of Medical Investigation
Faculty of Medicine Tokushima University
jmi_62_3-4_242.pdf 312 KB