Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 4
Abstract
Objectives: The risk of hip dislocation after revision total hip arthroplasty can be as high as 27% following surgery for periprosthetic fractures. A novel technique described by the senior authors in 2015, involving a transtrochanteric osteotomy and minimal superior capsulotomy, minimises this risk. Design: Prospective cohort study Setting: Sir Charles Gairdner Hospital, Hollywood Private Hospital Patients: Forty-two patients with Vancouver B type periprosthetic hip fractures, fixed using our superior capsulotomy technique. Intervention: The approach involves extending the fracture proximally to the tip of the greater trochanter, splitting the gluteal tendons and superior capsule in the same plane, in a titrated manner such that the head dislocates from the socket with a ‘pop’. The femoral component is revised and the cup and liner retained. Main Outcome Measurements: The primary outcome of interest was dislocation rate. Results: Patients averaged 80 years of age. Mean follow up was 31 months (range 12 months to 5 years). The primary finding was zero cases of hip joint dislocation. The average Oxford hip score was 31/48, the physical component and mental component Short Form 12 mean scores were 31.7 and 53.6 respectively at 1 year following revision. Functional scores did not significantly thereafter at 2 and 5 years. Mean subsidence at 1-year post operatively was 8.73mm. Two stems were revised. Conclusion: The outcomes of this operative technique in revision arthroplasty of Vancouver B periprosthetic hip fractures is promising, with no cases of hip dislocation, along with satisfactory patient clinical outcomes. Level of Evidence: Prospective Cohort Study, Level II.
Authors and Affiliations
Senthuren Isaac, Riaz JK Khan, Daniel P Fick, Lorcan Mcgonagle, Samantha Haebich
Keywords
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- EP ID EP488069
- DOI 10.22271/ortho.2018.v4.i4h.75
- Views 114
- Downloads 0
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