Periprosthetic femoral fractures after total hip arthroplasty

Abstract

Introduction. Perioprosthetic Femoral fractures occur in approximately 0,1% to 6% of all patients who have a total hip arthroplasty (THA) . Periprosthetic femoral fractures are found mostly in elderly women with osteopenia or in patients who have had loosening of the femoral component. Periprosthetic fractures around the femoral stem after THA represent a significant and growing technical challenge for othopaedic surgeons, requiring proficiency in both: THA and trauma care. Femoral fractures at the tip of a stem of a THA (Vancouver type B1 fractures) occur in 75% of all patients with periprosthetic fractures. Aim of the study. To analyze the statistics of Orthopedics and Traumatology Hospital for the purpose of corelating them with the international statistics, and to demonstrate the incident rate of periprosthetic femoral fractures of all the revisions of hip arthroplasty that were performed in 2017-2019 years. Materials and methods. The study group consisted of 23 cases of periprosthetic femoral fractures after hip arthroplasty treated between 2017 – 2019, 9 males and 14 females. Fractures were classified according to the Vancouver system and stratified as to treatment method. Results. According to the study, out of 23 patients with periprosthetic femoral fracrures, 5 of them were Vancouver type B1 fracture, 4 - type B2, 6 patients type B3 and 6 of them type C fractures. According to the statistics, 9 patients with periprosthetic fractures have the age between 70-80 years, 4 of them have the age between 50-60 years and 3 more than 80 years. Conclusions. The results of the analysis shows us that periprosthetic femoral fractures appear in 20% of all the revisions of hip arthroplasties. The periprosthetic femoral fractures have a higher incidence because of the growth of THA, that is why a surgeon that performs a THA should be prepared for a possible revision of hip arthroplasty.