Outcome after treatment of Vancouver B2 peri-prosthetic femoral fractures: revision arthroplasty and compression cerclage system fixation

Background: Peri-prosthetic femoral fractures after total hip arthroplasty (THA) are increasing year by year. The aim of this study was to evaluate the treatment effect of Vancouver B2 peri-prosthetic femoral fractures using uncemented revision with compression cerclage system (CCS). Methods: Fourteen patients with a diagnosis of Vancouver type B2 fracture were enrolled between 2002 and 2013. All patients were managed by revision arthroplasty, using cementless femoral long stems with CCS were used to aid the reconstruction where indicated. Results: All the fractures had both clinical and radiological union. The outcome was optimal, subjectively as satisfactory by all patients and this is substantiated objectively, by a post operative mean Harris hip score of 83.0. For Vancouver B2 peri-prosthetic femoral fracture, long stemmed revision was suggested with good clinical outcome. The use of non-cemented implants at revision surgery seemed a natural progression. And CCS is a promising strategy with several advantages. Conclusions: Uncemented revision with CCS system appears to be an attractive option for peri-prosthetic fractures (PPF) with unstable femoral stems.