title: Revision arthroplasty for periprosthetic femoral fracture using an uncemented modular tapered conical stem.
abstract: Periprosthetic femoral fracture (PFF) is a potentially devastating complication after total hip arthroplasty, with historically high rates of complication and failure because of the technical challenges of surgery, as well as the prevalence of advanced age and comorbidity in the patients at risk. This study describes the short-term outcome after revision arthroplasty using a modular, titanium, tapered, conical stem for PFF in a series of 38 fractures in 37 patients. The mean age of the cohort was 77 years (47 to 96). A total of 27 patients had an American Society of Anesthesiologists grade of at least 3. At a mean follow-up of 35 months (4 to 66) the mean Oxford Hip Score (OHS) was 35 (15 to 48) and comorbidity was significantly associated with a poorer OHS. All fractures united and no stem needed to be revised. Three hips in three patients required further surgery for infection, recurrent PFF and recurrent dislocation and three other patients required closed manipulation for a single dislocation. One stem subsided more than 5 mm but then stabilised and required no further intervention. In this series, a modular, tapered, conical stem provided a versatile reconstruction solution with a low rate of complications.
authors.affiliation: Western Sussex Hospitals NHS Foundation Trust, Lyndhurst Road, Worthing, BN11 2DH, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: da Assunção
authors.affiliation: Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK.
authors.forename: T C B
authors.initials: TC
authors.lastname: Pollard
authors.affiliation: University Hospitals Bristol NHS Trust Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK.
authors.forename: A
authors.initials: A
authors.lastname: Hrycaiczuk
authors.affiliation: Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA, 6009, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Curry
authors.affiliation: University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Glyn-Jones
authors.affiliation: Oxford University Hospitals NHS Trust, Windmill Road, Headington, Oxford, OX3 7HE, UK.
authors.forename: A
authors.initials: A
authors.lastname: Taylor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D015897:Comorbidity; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: Periprosthetic hip fracture; Revision