Cement-in-cement versus uncemented modular stem revision for Vancouver B2 periprosthetic fractures

John W Kennedy; Alex Hrycaiczuk; Nigel Y B Ng; Owen Sheerins; Sanjeev R Patil; Bryn G Jones; Andrew Stark; R M Dominic Meek

doi:10.1016/j.jor.2022.03.008

Cement-in-cement versus uncemented modular stem revision for Vancouver B2 periprosthetic fractures

J Orthop. 2022 Mar 26:31:124-128. doi: 10.1016/j.jor.2022.03.008. eCollection 2022 May-Jun.

Authors

John W Kennedy¹, Alex Hrycaiczuk², Nigel Y B Ng¹, Owen Sheerins², Sanjeev R Patil¹, Bryn G Jones², Andrew Stark², R M Dominic Meek¹

Affiliations

¹ Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.
² Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.

Abstract

Background: To compare outcomes of revision to a long uncemented stem with cement-in-cement revision for Vancouver B2 periprosthetic fracture (PPF).

Methods: Patients undergoing surgery for a Vancouver B2 PPF in a cemented stem from 2008 to 2018 were identified using our prospectively collated database.

Results: We identified 43 uncemented and 29 cement-in-cement revisions. Cement-in-cement revision had a shorter operative time, reduction in certain complications, no increased rate of non-union, lower degree of stem subsidence and no difference in re-revision rate.

Conclusion: With appropriate patient selection, both cement-in-cement and long uncemented stem revision represent appropriate treatment options for Vancouver B2 fractures.

Keywords: Cement-in-cement; Periprosthetic fracture; Revision total hip arthroplasty; Vancouver classification.