title: Vancouver type B2 and B3 periprosthetic fractures treated with revision total hip arthroplasty.
abstract: OBJECTIVE
  Periprosthetic fractures are the fourth most common cause for hip revision and a devastating complication. Our purpose is to report results and quality of life following revision THA for Vancouver B2 and B3 fractures.
  
  
  METHODS
  This was a retrospective review from January 2000 to November 2012 to identify all revision THA performed for Vancouver types B2 and B3 that had a minimum follow-up of two years. Routine post-operative and radiographic evaluation to assess patient survival, implant failure, complications and quality of life was involved. Statistical analysis was made with the Kaplan-Meier survival curve with 95 % confidence interval and the log rank (Mantel-Cox) test.
  
  
  RESULTS
  A total of 76 fractures were included, with an average follow-up 74.4 months. Mean age at the revision surgery was 75.7 years (range, 41-97 years; SD, 12.4). Sixty-six cases were classified as Vancouver B2 and treated with distal fixation stem. Ten cases were Vancouver B3 and a proximal femoral allograft technique was used. The overall five-year Kaplan-Meier survival rate for the patients was 77.9 % (95 % CI, 67.4-88.4), and the ten-year rate was 65.1 % (95 % CI, 51.4-78.8). Five-year Kaplan-Meier survival rate for the implants was 89.6 % (95 % CI, 82.2-97); we presented seven failures. The mean SF-12 mental was 55.1 (range, 31-68; SD, 8.1) and the physical was 37.4 (range, 16-55; SD, 9.4).
  
  
  CONCLUSIONS
  Mortality rate after periprosthetic fractures is high as compared to other hip surgeries; our Kaplan-Meier analysis showed that it tends to plateau after five years. In our series the failure rate was low and occurred early in the post-operative period.
authors: Instituto Traumatológico de Santiago, San Martín 771, Santiago, RM, 8340220, Chile. tomasamenabar@gmail.com.|MEDS Sports Clinic, Santiago, Chile. tomasamenabar@gmail.com.
authors: Tomas
authors: T
authors: Amenabar
authors: Mansoura University, Mansoura, Egypt.
authors: Wael A
authors: WA
authors: Rahman
authors: Division of Arthroplasty, Orthopaedic Surgery Department, Mount Sinai Hospital, Toronto, ON, Canada.
authors: Vineet V
authors: VV
authors: Avhad
authors: Instituto Traumatológico de Santiago, San Martín 771, Santiago, RM, 8340220, Chile.
authors: Ramiro
authors: R
authors: Vera
authors: Division of Arthroplasty, Orthopaedic Surgery Department, Mount Sinai Hospital, Toronto, ON, Canada.
authors: Allan E
authors: AE
authors: Gross
authors: Division of Arthroplasty, Orthopaedic Surgery Department, Mount Sinai Hospital, Toronto, ON, Canada.
authors: Paul R
authors: PR
authors: Kuzyk
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies
keywords: Hip revision; Periprosthetic fractures; Vancouver classification