BACKGROUND:
Periprosthetic femoral fractures following total hip arthroplasty are
becoming more prevalent. When a fracture occurs in a femur with substantial
proximal bone deficiency, the surgical options for revision are limited. One
option includes the use of a proximal femoral allograft.
METHODS:
We retrospectively assessed the results and complications of the use of a
proximal femoral allograft to treat twenty-five Vancouver type-B3
periprosthetic fractures in twenty-four patients. The mean duration of
follow-up was 5.1 years. Clinical results were graded with use of the Harris
hip score. Radiographs were assessed for evidence of trochanteric union,
host-allograft union, allograft resorption, and component loosening or
fracture. Failure of the procedure was defined as the need for revision
surgery requiring graft removal.
RESULTS:
The mean postoperative Harris hip score was 70.8. At the time of the final
follow-up, twenty-one of the twenty-four patients reported no or mild pain and
twenty-three patients were able to walk; fifteen required a walking aid. The
greater trochanter united in seventeen of the twenty-five hips (68%), and
osseous union of the allograft to the host femur occurred in twenty hips
(80%). There was mild graft resorption in four hips and moderate graft
resorption in two. Four (16%) of the twenty-five hips required repeat
revision.
CONCLUSIONS:
The use of a proximal femoral allograft for the treatment of a Vancouver
type-B3 periprosthetic femoral fracture can provide a satisfactory
result in terms of pain relief and function at five years.