A New Technique in Revision Hip Arthroplasty for Vancouver B Periprosthetic Fractures

Abstract

We describe a new revision technique for Vancouver B periprosthetic hip fractures that leaves the original acetabular components in situ and causes minimal damage to the hip capsule. Twenty-eight patients, average age 79, with Vancouver B periprosthetic fracture had femoral component revision using a modified trochanteric osteotomy with a minimal superior hip capsulotomy. A modular uncemented stem was used with or without cortical strut allograft. The acetabular component was not revised. Fractures occurred in 19 cemented implants and 9 uncemented implants. There were no dislocations. Seventeen patients were available for follow-up at 24 months (range, 3 to 60 mo), average Oxford hip score was 32.2; and Harris hip score 69.7. This new technique has shown good results. We believe that the absence of dislocation in this series is largely attributable to minimal capsular dissection.