title: Periprosthetic fractures with extensive bone loss treated with onlay strut allografts.
abstract: We reviewed a consecutive series of 19 patients with comminuted periprosthetic fractures, loosening of the femoral stem (Vancouver type B3) and significant loss of bone stock (Paprosky type III and IV). Sixteen porous-coated long stems and three Exeter stems, all with impaction grafting, were used. Large femoral onlay strut allografts were applied to maintain fracture reduction and improve stability. There was one early re-fracture at the tip of the femoral stem. Eighteen fractures healed without deformity and shortening. At the last follow-up at mean 3.7 (2.0-7.5) years, the mean Harris hip score was 76.4 (57.5-92.0). There was ingrowth of all strut grafts and significant augmentation of periprosthetic bone.
authors.affiliation: Department of Orthopaedic Surgery, University of Essen, Hufelandstr. 55, 45147 Essen, Germany. b.barden@uni-essen.de
authors.forename: B
authors.initials: B
authors.lastname: Barden
authors.forename: M
authors.initials: M
authors.lastname: von Knoch
authors.forename: J G
authors.initials: JG
authors.lastname: Fitzek
authors.forename: F
authors.initials: F
authors.lastname: Löer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000473:pathology*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D014184:Transplantation, Homologous; D016896:Treatment Outcome