TY - JOUR
T1 - Use of Locking Plate and Strut Onlay Allografts for Periprosthetic Fracture Around Well-Fixed Femoral Components
AU - Kim, Young Hoo
AU - Mansukhani, Sameer Ajit
AU - Kim, Jun Shik
AU - Park, Jang Won
N1 - Funding Information:
This work was supported by the Ewha Womans University research grant of 2013.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background The purpose of this study was to determine: validated clinical and radiographic outcomes of periprosthetic femoral fractures around stable hip implants treated with plate fixation and additional cortical strut onlay allografts without revision of the stem; radiographic signs of fracture healing; allograft-to-host bone union; resorption of cortical strut allograft; and frequency of complications. Methods At our institute, 24 patients (25 hips) were identified with Vancouver type B1 fracture at the tip of the femoral stem and one patient (one hip) was identified with a Vancouver type C fracture of the femur. All these fractures were treated with combined use of locking plate fixation and cortical strut onlay allografts. There were 18 women and 7 men, with an average age of 63 years. Harris hip score and University of California, Los Angeles activity score were used to assess postoperative function. The average duration of follow-up was 3.7 years (range, 1-7 years). Results Harris hip score at final review was 86 points (range, 65-95 points). University of California, Los Angele activity score averaged 5.8 ± 1.3 point (range, 3.5-10 points) at final follow-up. All but 2 patients returned to their preoperative functional level within 1 year. Twenty-three of 26 hips had fracture union following the first operation. Three hips were failed to obtain fixation because of insufficient length of plate and allograft. Cortical strut onlay allografts were incorporated in the host femur in all hips by one year. Minor resorption of allograft was noticed, but there was no failure of any of the cortical strut allografts. Conclusion The cortical strut onlay allografts facilitated the mechanical stability and the biological fracture healing in addition to plate fixation.
AB - Background The purpose of this study was to determine: validated clinical and radiographic outcomes of periprosthetic femoral fractures around stable hip implants treated with plate fixation and additional cortical strut onlay allografts without revision of the stem; radiographic signs of fracture healing; allograft-to-host bone union; resorption of cortical strut allograft; and frequency of complications. Methods At our institute, 24 patients (25 hips) were identified with Vancouver type B1 fracture at the tip of the femoral stem and one patient (one hip) was identified with a Vancouver type C fracture of the femur. All these fractures were treated with combined use of locking plate fixation and cortical strut onlay allografts. There were 18 women and 7 men, with an average age of 63 years. Harris hip score and University of California, Los Angeles activity score were used to assess postoperative function. The average duration of follow-up was 3.7 years (range, 1-7 years). Results Harris hip score at final review was 86 points (range, 65-95 points). University of California, Los Angele activity score averaged 5.8 ± 1.3 point (range, 3.5-10 points) at final follow-up. All but 2 patients returned to their preoperative functional level within 1 year. Twenty-three of 26 hips had fracture union following the first operation. Three hips were failed to obtain fixation because of insufficient length of plate and allograft. Cortical strut onlay allografts were incorporated in the host femur in all hips by one year. Minor resorption of allograft was noticed, but there was no failure of any of the cortical strut allografts. Conclusion The cortical strut onlay allografts facilitated the mechanical stability and the biological fracture healing in addition to plate fixation.
KW - clinical results
KW - locking plate
KW - periprosthetic fracture
KW - radiographic results
KW - strut onlay allograft
KW - well-fixed femoral component
UR - http://www.scopus.com/inward/record.url?scp=85002588174&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2016.05.064
DO - 10.1016/j.arth.2016.05.064
M3 - Article
C2 - 27407037
AN - SCOPUS:85002588174
SN - 0883-5403
VL - 32
SP - 166
EP - 170
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 1
ER -