Vancouver B periprosthetic fractures involving the Exeter cemented stem

Aims The aim of this study was to determine whether fixation, as opposed revision arthroplasty, can be safely used treat reducible Vancouver B type fractures in association with a cemented collarless polished tapered femoral stem (the Exeter). Methods This retrospective cohort assessed 152 operatively managed consecutive unilateral involving Exeter stems; 130 were open reduction and internal fixation (ORIF) 22 arthroplasty. Mean follow-up 6.5 years (SD 2.6; 3.2 12.1). primary outcome measure at least one component. Kaplan–Meier survival analysis performed. Regression identify risk factors for following ORIF. Secondary outcomes included any reoperation, complications, blood transfusion, length hospital stay, mortality. Results Fractures (B1 n = 74 (49%); B2 50 (33%); B3 28 (18%)) occurred median 4.2 (interquartile range (IQR) 1.2 9.2) after total hip arthroplasty (THA) (n 138) or hemiarthroplasty 14). Rates reoperation significantly higher compared ORIF (p 0.001) 0.050). Five-year better ORIF: 92% (95% confidence interval (CI) 86.4% 97.4%) versus 63% CI 41.7% 83.3%), p < 0.001. associated reduced transfusion requirement reoperations, but there no differences medical mortality between surgical groups. No independent predictors identified: where the bone-cement interface intact, not an increased revision. Conclusion When intact fracture anatomically reducible, all around stems could Fixation need lower surgery Cite article: Bone Joint J 2021;103-B(2):309–320.