Outcomes of treatment of periprosthetic femoral fractures after total hip replacement - experience of department of orthopedics and traumatology, medical university of Warsaw

Ortop Traumatol Rehabil. 2014 May-Jun;16(3):265-74. doi: 10.5604/15093492.1112283.

Abstract

Background: As more and more hip replacement procedures are being performed, the incidence of periprosthetic femoral fractures is also growing. The aim of the study was to assess the outcomes of periprosthetic fracture treatment with the use of the functional Harris Hip Score (HHS). It compares the outcomes of periprosthetic fracture treatment and prefracture treatment results obtained during follow-up outpatient consultations.

Material and methods: The study involved 65 patients divided into the following four groups, depending on the type of the primary procedure: patients with periprosthetic femoral fractures after hip hemiarthroplasty; patients after cemented total hip replacement; patients after cementless arthroplasty; and patients after revision hip arthroplasty. The types of fractures were classified according to the Vancouver scale.

Results: The HHS questionnaires showed a deterioration of treatment outcomes in all patients from the four groups as compared with the outcomes obtained prior to the fracture. The most pronounced decrease in functional outcomes was observed in the group of patients after hemiarthroplasty and revision hip replacement.

Conclusions: 1. The outcomes of periprosthetic fracture treatment, assessed with the HHS, are worse than the results obtained prior to the fracture. 2. Good results of periprosthetic fracture treatment were obtained only in patients with Vancouver Type B1 fractures. 3. The presence of co-morbidities in elderly patients contributes to a poorer final result of periprosthetic fracture treatment.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Female
  • Femoral Fractures / surgery*
  • Fracture Fixation, Internal / methods*
  • Fracture Fixation, Internal / statistics & numerical data*
  • Fracture Healing
  • Humans
  • Male
  • Middle Aged
  • Periprosthetic Fractures / etiology*
  • Periprosthetic Fractures / surgery*
  • Poland
  • Reoperation / statistics & numerical data*
  • Treatment Outcome