Cementless, modular, titanium stem in Vancouver B2 and B3 periprosthetic femoral fractures.

Eur J Orthop Surg Traumatol

Roger Salengro Hospital, University of Lille 2, Hauts de France, 59000, Lille, France.

Published: May 2023

Introduction: The periprosthetic femoral fracture (PFF) is a serious complication after primary total hip arthroplasty. We conducted a retrospective study to determine whether the PRIUS system presented similar survival to other existing implants for the treatment of Vancouver B2 or B3 PFFs. Bone consolidation rate, functional results and complications were analysed.

Method: This is a bi-centric retrospective study between 2012 and 2017 including 39 patients with (B2/B3) PFFs treated by senior surgeons using a PRIUS femoral implant. Implant survival, radiological outcome (fracture healing) and clinical scores (Oxford-OHS, Harris Hip Score-HHS, Postel Merle d'Aubigné-PMA, Devane and Charnley) were analysed. 10 patients had died before data collection and 5 patients were lost to follow-up. A total of 21 patients were able to undergo a clinical and radiological evaluation. The mean follow-up period was 3 years.

Results: The 3-year PRIUS stem survival rate was 88.6% [95% CI, 77.2-100]. The consolidation rate was 81% (17/21). The rate of satisfied or very satisfied patients was 85.6% (18/21). Regarding the Devane score, activity level was maintained in 70.6% of cases (12/17) and decreased in 29.4% of cases (5/17), the Charnley score was stable in 94% of cases (16/17) and decreased in 6% of cases (1/17). The mean Oxford score was 28.8/48 (9.3; 16-48), the mean HHS was 67/100 (16.4; 46-91) and the mean PMA score was 12.6/18 (4.5; 2-18).

Conclusion: The results in terms of survival rate and bone consolidation are comparable to other literature series. The PRIUS® System can be added to the surgical arsenal in the treatment of (B2/B3) PFF, subject to confirmation of these results in the longer term.

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http://dx.doi.org/10.1007/s00590-022-03267-2DOI Listing

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