Abstract
The management of periprosthetic femoral fractures associated with a total hip arthroplasty remains controversial. The 2003 AAOS Instructional Course Lecture states “Regardless of the method of fixation, the fracture site should be bone grafted with morcellised allograft.” We do not believe bone grafting is necessary to obtain union .
Forty six periprosthetic femoral fractures associated with a total hip were reviewed retrospectively. Follow up included chart and radiographic review, Oxford Hip Score, and SF-12. All fractures were classified acording to the Vancouver classification.
There were 31 type B fractures and 15 type C fractures. All fractures healed. The mean healing time was 15 weeks. No allograft was used. The mean Oxford Hip Score was 26, and the SF-12 33. There were a number of complications, primarily dislocation in the more severe fractures.
The results of this series indicate that bone graft is not necessary to obtain union in periprosthetic femoral fractures. The use of allograft is associated with possible disease and infection transmission and increased cost, risks that we do not believe are justified.
Correspondence should be addressed to Richard Komistek, PhD, International Society for Technology in Arthroplasty, PO Box 6564, Auburn, CA 95604, USA. E-mail: ista@pacbell.net
