Management of Vancouver type B1 and C periprosthetic fractures in elderly patients requires fixation and an aim for early mobilisation but many techniques restrict weightbearing due to re-fracture risk. We present the clinical and radiographic outcomes of our technique of total femoral plating (TFP) to allow early weightbearing whilst reducing risk of re-fracture. A single-centre retrospective cohort study was performed including twenty-two patients treated with TFP for fracture around either hip or knee replacements between May 2014 and December 2017. Follow-up data was compared at 6, 12 and 24 months. Primary outcomes were functional scores (Oxford Hip or Knee score (OHS/OKS)), Quality of Life (EQ-5D) and satisfaction at final follow-up (Visual Analogue Score (VAS)). Secondary outcomes were radiographic fracture union and complications.Introduction
Methods
We present the medium to long term clinical results of 112 Uncemented custom Computer Assisted Design Computer Assisted Manufactured (CAD-CAM) total hip arthroplasties performed between 1992 and 1998 in 111 patients. Fifty three males and 58 females were included. Mean age was 46.2 years (range 24.6yrs - 62.2 yrs). Average duration of follow up was 156 months (120 – 204 months). The mean Harris Hip Score (HHS) improved from 42.4 to 90.3, mean Oxford Hip Score (OHS) improved from 43.1 to 18.2 and the mean WOMAC hip score improved from 57.0 to 11.9. There was 1 revision due to failure of the acetabular components but there were no failures of the femoral components. There were no revisions for aseptic loosening. The worst case survival in this cohort of custom femoral components at an average 13 year follow up (range 10-17 years) was 98.2% (95% Confidence interval 95% to 99%). Survival of the femoral component alone was 100%. These results are comparable with the best medium to long term results for femoral components used in primary total hip arthroplasty (THA) with any means of fixation.
