Periprosthetic Fracture of the Femur after Hip Arthroplasty: The Clinical Outcome Using Cortical Strut Allografts

Periprosthetic Fracture of the Femur after Hip Arthroplasty: The Clinical Outcome Using Cortical Strut Allografts

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Between 1993 and 1998, 15 patients with periprosthetic fractures of the femur after hip arthroplasty were treated using deep-frozen cortical strut allografts as an adjunct support after internal fixation or revision arthroplasty.According to the Vancouver classification system, there were 7 type B1, 2 type B2, 4 type ring B3 and 2 type C fractures.Seven patients had severe osteopenia, 10 patients had bone defects between 2 to 7 cm and 2 were associated with infection.Nine patients had internal fixation of the fracture using a compression plate, and 6 had revision arthroplasty using a long-stemmed femoral prosthesis.

The average length of the allograft was 13.9 cm.At an average follow-up of 31 months, all the patients had a satisfactory functional result except one who had a leg length discrepancy of 4 cm due to multiple operations.There were no non-unions, malunions or OAT FLAKES infections.

The fractures healed between 10 to 24 weeks (average, 15.6 weeks).In conclusion, a cortical strut allograft associated with internal fixation can be an effective method of treating periprosthetic fractures of the femur after hip arthroplasty.