Reconstructed the bone stock after femoral bone loss in Vancouver B3
periprosthetic femoral fractures using cortical strut allograft
and impacted cancellous allograft
Received: 15 January 2018 /Accepted: 18 May 2018
SICOT aisbl 2018
Aims This study was performed to evaluate the efficacy of reconstructing bone stock in Vancouver B3 periprosthetic femoral
fractures (PFFs) using an impacted cancellous allograft cortical or combined with cortical strut allograft.
Patients and methods We retrospectively assessed 39 Vancouver-type B3 periprosthetic fractures in 39 patients. Having differ-
ent bone defects in the femur, 20 patients were treated with intramedullary impacted cancellous allograft, and 19 patients were
treated with impacted cancellous allograft combined with cortical strut allograft. The median follow-up time was 58 months.
Results Thirty-three patients completed the follow-up as scheduled, and three of them underwent re-operation (9.1%, 3/33). The
last evaluated mean hip Harris score was 81.8; WOMAC pain, stiffness, and function scores were 82.3, 79.0, and 81.3,
respectively. The satisfaction score was 86.6, and the SF-12 mental and physical scores were 40.4 and 51.1, respectively, for
all patients. These outcomes were without significant difference between the two treatment groups (p > 0.05). The facture union
was achieved in all the hips (100%). The stem was fixed with bone ingrowth in 24 patients and with fibrous fixation in eight,
while stem fixation was not achieved for the remaining patient. The stem subsided less than 3 mm in 23 patients and 3–5mmin
nine patients. One patient had > 5 mm subsidence. The femoral bone stock was improved in 18 patients and remained unchanged
in 14 patients; only one patient suffered a diminished bone stock. The radiographic assessment outcomes exhibited little
difference between the two treatment groups (p > 0.05). Osseous union of the cortical strut to the host femur occurred in six
patients with partial union and ten with complete union. There was moderate and mild graft resorption in three and 13 hips,
Conclusions The use of impacted cancellous allograft and cortical strut allograft to reconstruct bone stock can provide reliable
options and satisfactory results.
Keywords Periprosthetic femoral fractures
Total hip arthroplasty
Donghai Li and Qinsheng Hu contributed equally to this work and should
be regarded as first co-authors.
* Pengde Kang
Yang ji ng @1 6 3 .co m
Department of Orthopaedics Surgery, West China Hospital, Sichuan
University, 37# Wainan Guoxue Road, Chengdu, Sichuan 610041,
People’s Republic of China