International Journal of Orthopaedics Sciences
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International Journal of Orthopaedics Sciences

2018, Volume 4 Issue 4

Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures

Author(s): Senthuren Isaac, Riaz JK Khan, Daniel P Fick, Lorcan Mcgonagle and Samantha Haebich
Abstract: 
Objectives: The risk of hip dislocation after revision total hip arthroplasty can be as high as 27% following surgery for periprosthetic fractures. A novel technique described by the senior authors in 2015, involving a transtrochanteric osteotomy and minimal superior capsulotomy, minimises this risk.
Design: Prospective cohort study
Setting: Sir Charles Gairdner Hospital, Hollywood Private Hospital
Patients: Forty-two patients with Vancouver B type periprosthetic hip fractures, fixed using our superior capsulotomy technique.
Intervention: The approach involves extending the fracture proximally to the tip of the greater trochanter, splitting the gluteal tendons and superior capsule in the same plane, in a titrated manner such that the head dislocates from the socket with a ‘pop’. The femoral component is revised and the cup and liner retained.
Main Outcome Measurements: The primary outcome of interest was dislocation rate.
Results: Patients averaged 80 years of age. Mean follow up was 31 months (range 12 months to 5 years). The primary finding was zero cases of hip joint dislocation. The average Oxford hip score was 31/48, the physical component and mental component Short Form 12 mean scores were 31.7 and 53.6 respectively at 1 year following revision. Functional scores did not significantly thereafter at 2 and 5 years. Mean subsidence at 1-year post operatively was 8.73mm. Two stems were revised.
Conclusion: The outcomes of this operative technique in revision arthroplasty of Vancouver B periprosthetic hip fractures is promising, with no cases of hip dislocation, along with satisfactory patient clinical outcomes.
Level of Evidence: Prospective Cohort Study, Level II.

Pages: 631-636  |  270 Views  5 Downloads
How to cite this article:
Senthuren Isaac, Riaz JK Khan, Daniel P Fick, Lorcan Mcgonagle and Samantha Haebich. Maximising stability after revision hip arthroplasty for vancouver B periprosthetic fractures. International Journal of Orthopaedics Sciences. 2018; 4(4): 631-636. DOI: 10.22271/ortho.2018.v4.i4h.75