Effectiveness of shape memory alloy embracing device in treatment of Vancouver B2 periprosthetic femoral fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Yiyang , CHEN Yang , KONG Ning , TIAN Run , WANG Kunzheng ,  YANG Pei

Department of Bone and Joint Surgery, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an Shaanxi, 710004, P. R. China;

Corresponding?author：

YANG Pei, Email: yangpei@xjtu.edu.cn

Keywords：

Periprosthetic femoral fracture; shape memory embracing device; hip arthroplasty; complication; internal fixation

DOI：

10.7507/1002-1892.202204128

Video：

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Objective To analyze the effectiveness of shape memory alloy embracing device in the treatment of Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty. Methods The clinical data of 30 patients (30 hips) with Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty between January 2019 and January 2021 were analyzed retrospectively. Among them, 15 cases were treated with shape memory alloy embracing device for fracture fixation (group A) and 15 cases with titanium cable cerclage (group B). There was no significant difference in general data such as gender, age, body mass index, the cause of primary arthroplasty and surgical method, prosthesis type, the cause and side of femoral fracture, the time from injury to operation, and comorbidities between the two groups (P>0.05). The operation time, intraoperative blood loss, and hospital stay of the two groups were recorded. The fracture healing was examined by X-ray film, and the hip joint function was evaluated by Harris score. Results The operations in both groups were completed successfully, and the incisions healed by first intention after operation with no vascular or nerve injury. The operation time and hospital stay in group A were significantly shorter than those in group B (P<0.05), but there was no significant difference in intraoperative blood loss between group A and group B (t=?0.518, P=0.609). Patients were followed up 12-20 months (mean, 16.3 months) in group A and 12-22 months (mean, 16.7 months) in group B. X-ray film showed that all fractures healed, the healing time was (14.73±2.05) weeks in group A and (17.27±2.60) weeks in group B, and there was a significant difference between the two groups (t=?2.960, P=0.006). During follow-up, there was no complication such as prosthesis loosening, periprosthetic infection, joint stiffness, or internal fixator loosening. The Harris score of group A was significantly better than that of group B at 3, 6, and 12 months after operation (P<0.05). Conclusion Compared with titanium cable cerclage, using shape memory alloy embracing device to fix Vancouver B2 periprosthetic femoral fracture can accelerate fracture healing, shorten operation time, and reduce intraoperative blood loss. Patients can perform functional exercise earlier and restore joint function better.

Citation： LI Yiyang, CHEN Yang, KONG Ning, TIAN Run, WANG Kunzheng, YANG Pei. Effectiveness of shape memory alloy embracing device in treatment of Vancouver B2 periprosthetic femoral fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(10): 1244-1248. doi: 10.7507/1002-1892.202204128 Copy

1.	胡和軍, 單記春, 鄧雄偉, 等. 人工髖關節置換術后股骨假體周圍骨折的治療及預防策略. 中國骨與關節損傷雜志, 2018, 33(4): 403-405.
2.	董巍, 張天一, 路博, 等. Vancouver B2型股骨假體周圍骨折鎖定板或皮質骨板不同內固定方式的生物力學分析. 中國組織工程研究, 2021, 25(30): 4787-4792.
3.	Abdel MP, Houdek MT, Watts CD, et al. Epidemiology of periprosthetic femoral fractures in 5 417 revision total hip arthroplasties: a 40-year experience. Bone Joint J, 2016, 98-B(4): 468-474.
4.	Brodén C, Mukka S, Muren O, et al. High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem. Acta Orthop, 2015, 86(2): 169-174.
5.	Ciriello V, Chiarpenello R, Tomarchio A, et al. The management of Vancouver B1 and C periprosthetic fractures: radiographic and clinic outcomes of a monocentric consecutive series. Hip Int, 2020, 30(2_suppl): 94-100.
6.	Okudera Y, Kijima H, Yamada S, et al. The location of the fracture determines the better solution, osteosynthesis or revision, in periprosthetic femoral fractures. J Orthop, 2020, 22: 220-224.
7.	Munro JT, Garbuz DS, Masri BA, et al. Tapered fluted titanium stems in the management of Vancouver B2 and B3 periprosthetic femoral fractures. Clin Orthop Relat Res, 2014, 472(2): 590-598.
8.	郭旗, 張舜, 張傳林, 等. 股骨環抱器記憶合金治療Vancouver B1型股骨假體周圍骨折的臨床效果. 醫藥論壇雜志, 2020, 41(8): 41-44.
9.	Pavone V, de Cristo C, Di Stefano A, et al. Periprosthetic femoral fractures after total hip arthroplasty: An algorithm of treatment. Injury, 2019, 50 Suppl 2: S45-S51.
10.	李璐兵, 阿依丁·夏哈太, 李飛, 等. 老年髖關節術后發生假體周圍骨折的危險因素研究. 創傷外科雜志, 2021, 23(10): 740-743, 748.
11.	索海強. 人工髖關節置換術后股骨假體周圍骨折的治療及療效分析. 長春: 吉林大學, 2020.
12.	Abdel MP, Watts CD, Houdek MT, et al. Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience. Bone Joint J, 2016, 98-B(4): 461-467.
13.	鹿戰, 劉沛東, 史俊龍, 等. 髖關節置換術假體周圍骨折危險因素的Meta分析. 中國骨傷, 2019, 32(6): 557-563.
14.	Moreta J, Uriarte I, Ormaza A, et al. Outcomes of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty in elderly patients. Hip Int, 2019, 29(2): 184-190.
15.	Brady OH, Garbuz DS, Masri BA, et al. The reliability and validity of the Vancouver classification of femoral fractures after hip replacement. J Arthroplasty, 2000, 15(1): 59-62.
16.	康鵬德, 李東海, 裴福興. 全髖關節置換術后股骨假體周圍骨折的治療策略. 中華骨科雜志, 2019, 39(15): 961-972.
17.	Yasen AT, Haddad FS. The management of type B1 periprosthetic femoral fractures: when to fix and when to revise. Int Orthop, 2015, 39(9): 1873-1879.
18.	張斌. 記憶合金環抱器在四肢骨折中的應用. 中國醫藥導報, 2010, 7(20): 39, 42.
19.	胡智, 戴天陽. 鎳鈦記憶合金環抱器治療多發性肋骨骨折的臨床研究. 重慶醫學, 2013, 42(5): 502-503, 507.
20.	Zhao X, Zhu ZA, Sun YH, et al. Nickel-titanium shape-memory sawtooth-arm embracing fixator for periprosthetic femoral fractures. Int Orthop, 2012, 36(3): 619-626.

1. 胡和軍, 單記春, 鄧雄偉, 等. 人工髖關節置換術后股骨假體周圍骨折的治療及預防策略. 中國骨與關節損傷雜志, 2018, 33(4): 403-405.
2. 董巍, 張天一, 路博, 等. Vancouver B2型股骨假體周圍骨折鎖定板或皮質骨板不同內固定方式的生物力學分析. 中國組織工程研究, 2021, 25(30): 4787-4792.
3. Abdel MP, Houdek MT, Watts CD, et al. Epidemiology of periprosthetic femoral fractures in 5 417 revision total hip arthroplasties: a 40-year experience. Bone Joint J, 2016, 98-B(4): 468-474.
4. Brodén C, Mukka S, Muren O, et al. High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem. Acta Orthop, 2015, 86(2): 169-174.
5. Ciriello V, Chiarpenello R, Tomarchio A, et al. The management of Vancouver B1 and C periprosthetic fractures: radiographic and clinic outcomes of a monocentric consecutive series. Hip Int, 2020, 30(2_suppl): 94-100.
6. Okudera Y, Kijima H, Yamada S, et al. The location of the fracture determines the better solution, osteosynthesis or revision, in periprosthetic femoral fractures. J Orthop, 2020, 22: 220-224.
7. Munro JT, Garbuz DS, Masri BA, et al. Tapered fluted titanium stems in the management of Vancouver B2 and B3 periprosthetic femoral fractures. Clin Orthop Relat Res, 2014, 472(2): 590-598.
8. 郭旗, 張舜, 張傳林, 等. 股骨環抱器記憶合金治療Vancouver B1型股骨假體周圍骨折的臨床效果. 醫藥論壇雜志, 2020, 41(8): 41-44.
9. Pavone V, de Cristo C, Di Stefano A, et al. Periprosthetic femoral fractures after total hip arthroplasty: An algorithm of treatment. Injury, 2019, 50 Suppl 2: S45-S51.
10. 李璐兵, 阿依丁·夏哈太, 李飛, 等. 老年髖關節術后發生假體周圍骨折的危險因素研究. 創傷外科雜志, 2021, 23(10): 740-743, 748.
11. 索海強. 人工髖關節置換術后股骨假體周圍骨折的治療及療效分析. 長春: 吉林大學, 2020.
12. Abdel MP, Watts CD, Houdek MT, et al. Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience. Bone Joint J, 2016, 98-B(4): 461-467.
13. 鹿戰, 劉沛東, 史俊龍, 等. 髖關節置換術假體周圍骨折危險因素的Meta分析. 中國骨傷, 2019, 32(6): 557-563.
14. Moreta J, Uriarte I, Ormaza A, et al. Outcomes of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty in elderly patients. Hip Int, 2019, 29(2): 184-190.
15. Brady OH, Garbuz DS, Masri BA, et al. The reliability and validity of the Vancouver classification of femoral fractures after hip replacement. J Arthroplasty, 2000, 15(1): 59-62.
16. 康鵬德, 李東海, 裴福興. 全髖關節置換術后股骨假體周圍骨折的治療策略. 中華骨科雜志, 2019, 39(15): 961-972.
17. Yasen AT, Haddad FS. The management of type B1 periprosthetic femoral fractures: when to fix and when to revise. Int Orthop, 2015, 39(9): 1873-1879.
18. 張斌. 記憶合金環抱器在四肢骨折中的應用. 中國醫藥導報, 2010, 7(20): 39, 42.
19. 胡智, 戴天陽. 鎳鈦記憶合金環抱器治療多發性肋骨骨折的臨床研究. 重慶醫學, 2013, 42(5): 502-503, 507.
20. Zhao X, Zhu ZA, Sun YH, et al. Nickel-titanium shape-memory sawtooth-arm embracing fixator for periprosthetic femoral fractures. Int Orthop, 2012, 36(3): 619-626.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of shape memory alloy embracing device in treatment of Vancouver B2 periprosthetic femoral fracture

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