Immediate results of treatment periprosthetic femoral fractures after hip replacement

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Periprosthetic fractures are one of the most serious complications after hip replacement. Nineteen periprosthetic femoral fractures operated on during the period 2011-2015 were followed-up retrospectively. Periprosthetic fractures were classified according to the Vancouver classification. The functional results were evaluated using Harrison scale. Bone healing and implant stability were evaluated clinically, on plain radiographs and computed tomography. The periprosthetic fractures in all patients occurred in the postoperative period. Time from operation until fracture varied from 2 weeks to 11 years. A wedge-shaped cemented or cementless stems were implanted during the first surgery: Versys ET, Spotorno, CPT (Zimmer, США): cementless fixation was performed in 16 (84,2%) patients, hybrid -in 2 (10,5%) and cemented fixation - in 1 (5,3%) patient. The fractures of greater trochanter were diagnosed in all patients with type A periprosthetic fractures. In type B1 periprosthetic fracture (8 patients) open reduction, cerclage wiring and internal plate osteosynthesis were applied. Loosening stems in 3 patients with type B2 fractures were replaced with Wagner cementless revision component (Wagner SL Revision Stem). Angle-stable plate osteosynthesis and cerclage wiring were also performed. Closed reduction and internal minimal invasive plate osteosynthesis were performed in patients with type C periprosthetic fractures. Bone consolidation was achieved in 18 (94,7%) patients, the average term was 14,3±5,2 weeks. The average Harris hip score in all patients 3 months after treatment was 64,9±16,7 points, and in 12 patients (63,2%) after a year - 86,5±15,9. Femoral periprosthetic fractures require a specialized approach to choosing the treatment tactic depending on the fracture type and quality of bone tissue. It is necessary to evaluate the femoral component stability, especially in differential diagnosis of type B1 and B2 periprosthetic fractures. Computed tomography is one of the necessary methods of diagnosis.

About the authors

V. V. Khominets

Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

the head of department and clinic of military traumatology and orthopedics Russian Federation

P. A. Metlenko

Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Author for correspondence.
the head of orthopedic department Russian Federation

A. N. Bogdanov

Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

assistant Russian Federation

A. L. Kudyashev

Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

deputy head of the department and clinic of military traumatology and orthopedics Russian Federation

F. V. Miroevsky

Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

the orthopedic surgeon, the department of military traumatology and orthopedics Russian Federation


  1. Белов М.В., Ключевский В.В., Даниляк В.В., Гильфанов С.И., Ключевский Вас.В. Сравнение эффективности способов лечения перипротезных переломов бедра. Травматология и ортопедия России. 2006; (3):21-25.
  2. Ключевский В.В., Даниляк В.В., Гильфанов С.И., Белов М.В., Ключевский Вас.В. Современные подходы к лечению перипротезных переломов бедра. Гений ортопедии. 2008; (4):126-130.
  3. Тихилов Р.М., Воронкевич И.А., Малыгин Р.В., Ласунский С.А. Пластина для остеосинтеза перипротезных переломов бедренной кости. Травматология и ортопедия России. 2009; (2):117-122.
  4. Brodén C., Mukka S., Muren O., Eisler T., Boden H., Stark A., Sköldenberg O. High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem. Acta Orthop. 2015; 86(2):169-174.
  5. Duncan C.P., Marsi B.A. Fractures of the femur after hip replacement. Instr Course Lect. 1995; 44:293-304.
  6. F ink B. Revision arthroplasty in periprosthetic fractures of the proximal femur. Oper Orthop Traumatol. 2014; 6(5):455-468.
  7. F üchtmeier B., Galler M., Müller F. Mid-term results of 121 periprosthetic femoral fractures: increased failure and mortality within but not after one postoperative year. J Arthroplasty. 2014; 30(4)699-674.
  8. Graham S.M., Moazen M., Leonidou A., Tsiridis E. Locking plate fixation for Vancouver B1 periprosthetic femoral fractures: a critical analysis of 135 cases. J Orthop Sci. 2013; 18(3):426-436.
  9. Khan M., Della Valle C.J., Jacofsky D.J., Meneghini R.M., Haddad F.S. Early postoperative complications after total hip arthroplasty: current strategies for prevention and treatment. Instr Course Lect. 2015; 64:337-346.
  10. Kim Y., Tanaka C., Tada H., Kanoe H., Shirai T. Treatment of periprosthetic femoral fractures after femoral revision using a long stem. BMC Musculoskelet Disord. 2015; 10:106-113.
  11. Lunebourg A., Mouhsine E., Cherix S., Ollivier M., Chevalley F., Wettstein M. Treatment of type B periprosthetic femur fractures with curved non-locking plate with eccentric holes: Retrospective study of 43 patients with minimum 1-year follow-up. Orthop Traumatol Surg Res. 2015; 101(3):277-282.
  12. Mann T., Eisler T., Bodén H., Muren O., Stark A., Salemyr M., Sköldenberg O. Larger femoral periprosthetic bone mineral density decrease following total hip arthroplasty for femoral neck fracture than for osteoarthritis: a prospective, observational cohort study. J Orthop Res. 2015; 33(4):504-512.
  13. Nauth A., Nousiainen M.T., Jenkinson R., Hall J. The treatment of periprosthetic fractures. Instr Course Lect. 2015; 64:161-173.
  14. Ricci W.M. Periprosthetic femur fractures. J Orthop Trauma. 2015; 29(3):130-137.
  15. Sidler-Maier C.C., Waddell J.P. Incidence and predisposing factors of periprosthetic proximal femoral fractures: a literature review. Int Orthop. 2015; 39(9):1673-1682.
  16. Spina M., Rocca G., Canella A., Scalvi A. Causes of failure in periprosthetic fractures of the hip at 1- to 14-year follow-up. Injury. 2014; 45(6):85-92.
  17. Thien T.M., Chatziagorou G., Garellick G., Furnes O., Havelin L.I., Mäkelä K., Overgaard S., Pedersen A., Eskelinen A., Pulkkinen P., Kärrholm J. Periprosthetic femoral fracture within two years after total hip replacement: analysis of 437,629 operations in the Nordic arthroplasty register association database. J Bone Joint Surg Am. 2014; 96(19):e167.
  18. W atts C.D., Abdel M.P., Lewallen D.G., Berry D.J., Hanssen A.D. Increased risk of periprosthetic femur fractures associated with a unique cementless stem design. Clin Orthop Relat Res. 2015; 473(6):2045-2053.
  19. Y asen A.T., Haddad F.S. Periprosthetic fractures: bespoke solutions. Bone Joint J. 2014; 96-В(11):48-55.

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