Original Article

The impact of stem fixation method on Vancouver Type B1 periprosthetic femoral fracture management

¹ Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK
² Academic Orthopaedics Department, Papageorgiou General Hospital & CORE Lab at CIRI AUTH, Aristotle University Medical School, University Campus 54 124, Thessaloniki, Greece
³ Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
⁴ DePuy Synthes, St. Anthony’s Road, Leeds LS11 8DT, UK

^* Corresponding author: M.Moazen@ucl.ac.uk

Received: 10 November 2021
Accepted: 6 December 2021

Abstract

Introduction: Our understanding of the impact of the stem fixation method in total hip arthroplasty (THA) on the subsequent management of periprosthetic femoral fractures (PFF) is still limited. This study aimed to investigate and quantify the effect of the stem fixation method, i.e., cemented vs. uncemented THA, on the management of Vancouver Type B1 periprosthetic femoral fractures with the same plate. Methods: Eight laboratory models of synthetic femora were divided into two groups and implanted with either a cemented or uncemented hip prosthesis. The overall stiffness and strain distribution were measured under an anatomical one-legged stance. All eight specimens underwent an osteotomy to simulate Vancouver type B1 PFF’s. Fractures were then fixed using the same extramedullary plate and screws. The same measurements and fracture movement were taken under the same loading conditions. Results: Highlighted that the uncemented THA and PFF fixation constructs had a lower overall stiffness. Subsequently, the mechanical strain on the fracture plate for the uncemented construct was higher compared to the cemented constructs. Conclusion: PFF fixation of a Vancouver type B1 fracture using a plate may have a higher risk of failure in uncemented THAs.