Assessing the use of tapered titanium stems in treating periprosthetic fractures
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Date
2019
Authors
Derksen, Kieran
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Abstract
Background: Periprosthetic fractures are a late complication of total hip arthroplasty. There are a variety of surgical techniques and femoral component designs that can be used to treat them depending on surgeon preference and fracture type. Tapered titanium stems have shown promising results in recent studies for the treatment of periprosthetic fractures. Purpose: The objective of this retrospective study was to investigate the efficacy of using tapered titanium hip stems in a revision arthroplasty procedure for periprosthetic fracture repairs by assessing survivorship, radiographic findings, and self-reported functional outcomes at a post-operative period of at least 2 years. Methods: A total of 34 patients who received treatment for periprosthetic fractures between May 2008 and January 2016 were assessed for the use of tapered titanium stems. Survivability was determined and radiographs were evaluated for fracture union, stem subsidence, and osseous restoration. The Oxford questionnaire and satisfaction survey were used to determine quality of life, functionality, and pain scores. Results Three patients required early revisions after surgery for either trochanteric fracture and dislocation (5 months), infection (10 months), or aseptic loosening (4 months). Complete union was found in 88% of cases and bone stock was unchanged or increased in 91% of cases. Stem subsidence occurred in 44% of cases with a mean migration of 2.6 mm. Although there was a high occurrence of subsidence, the majority of cases measured less than 4 mm, and subsidence did not correlate with survivorship or clinical outcomes. The mean 2 year Oxford score was 37.8 of 48 and on average patients were either satisfied or very satisfied. Conclusions: This study reports encouraging radiographic and clinical results with minimum 2 year follow-up for the treatment of periprosthetic fractures with tapered titanium femoral stems.
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Periprosthetic fractures