Combined use of extensively porous coated femoral components with onlay cortical strut allografts in revision of Vancouver B2 and B3 periprosthetic femoral fractures

<正> Background Periprosthetic femoral fractures following total hip arthroplasty are getting more prevalent.The aim of thisstudy was to evaluate the clinical results of combined use of uncemented extensively porous coated femoral componentswith onlay cortical strut allografts in revision of Vancouver type B2 and B3 periprosthetic femoral fractures.Methods Thirteen hips after total hip arthroplasty in 13 patients who suffered a Vancouver B2 or B3 periprostheticfracture were treated with an uncemented extensively porous coated femoral component combined with onlay corticalstrut allografts.Each patient was assigned a Harris hip score,and a visual analog scale (VAS)score for pain andsatisfaction.Radiographs were examined for component stability,fracture site and allograft-host union and allograftreconstruction.Results At an average of 5.3-year follow-up,no patient required repeat revision.The average Harris hip score was(71.8±6.3)points,the pain VAS score was (16.6±4.3)points,and the patient satisfaction VAS score was (81.5±5.7)points.Radiographic examination showed no detectable loosening of the prostheses,and 12 cases were presented fixation byosseointegration and the other one was stable fibrous ingrown fixation.All fractures united for (5.2±1.4)months inaverage.And all onlay strut allografts united to host bone for about (11.5±2.6)months.Conclusions Combined use of uncemented,long stemmed,extensively porous coated implant with cortical onlay strutallografts can achieve good clinic results and high rate of union for both fracture site and allograft-host bone junction.Thistechnique could be used routinely to augment fixation and healing of Vancouver B2 and B3 periprosthetic fractures.