title: Successful Outcomes Using Interlocking Prostheses for Periprosthetic Fractures with Loose Femoral Components.
abstract: Periprosthetic femoral fractures with implant loosening are difficult to treat, especially when accompanied by severe bone loss. We report here the treatment outcomes of 4 patients (1 man, 3 women; age range 69-86 years) with periprosthetic femoral fractures and implant loosening after bipolar hemiarthroplasty. Fractures were classified according to the Vancouver classification as type B2 and B3, with adequate or compromised bone stock, respectively. One patient was initially treated conservatively but symptoms due to implant loosening persisted and revision surgery was required. All patients underwent revision using a long-stem cementless implant with interlocking screws as well as a cancellous allograft to augment the bone stock. At final follow-up (mean, 25 months), all patients had stable implant fixation, bony union of the fracture, and marked recovery of the proximal femoral bone stock through allograft use. This revision procedure achieved implant fixation and fracture healing with reconstitution of the femur even in the short term and even in cases with severe bone deficiency.
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tsutsui
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Goto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hamada
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tonogai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mineta
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Abe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsuura
authors.forename: Naoto
authors.initials: N
authors.lastname: Suzue
authors.forename: Shoji
authors.initials: S
authors.lastname: Fukuta
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000601:surgery*; D019736:Prostheses and Implants; D012086:Reoperation; D016896:Treatment Outcome