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.	胡和军, 单记春, 邓雄伟, 等. 人工髋关节置换术后股骨假体周围骨折的治疗及预防策略. 中国骨与关节损伤杂志, 2018, 33(4): 403-405.
2.	董巍, 张天一, 路博, 等. Vancouver B2型股骨假体周围骨折锁定板或皮质骨板不同内固定方式的生物力学分析. 中国组织工程研究, 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, 张舜, 张传林, 等. 股骨环抱器记忆合金治疗Vancouver B1型股骨假体周围骨折的临床效果. 医药论坛杂志, 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, 李飞, 等. 老年髋关节术后发生假体周围骨折的危险因素研究. 创伤外科杂志, 2021, 23(10): 740-743, 748.
11.	索海强. 人工髋关节置换术后股骨假体周围骨折的治疗及疗效分析. 长春: 吉林大学, 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.	鹿战, 刘沛东, 史俊龙, 等. 髋关节置换术假体周围骨折危险因素的Meta分析. 中国骨伤, 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.	康鹏德, 李东海, 裴福兴. 全髋关节置换术后股骨假体周围骨折的治疗策略. 中华骨科杂志, 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.	张斌. 记忆合金环抱器在四肢骨折中的应用. 中国医药导报, 2010, 7(20): 39, 42.
19.	胡智, 戴天阳. 镍钛记忆合金环抱器治疗多发性肋骨骨折的临床研究. 重庆医学, 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. 胡和军, 单记春, 邓雄伟, 等. 人工髋关节置换术后股骨假体周围骨折的治疗及预防策略. 中国骨与关节损伤杂志, 2018, 33(4): 403-405.
2. 董巍, 张天一, 路博, 等. Vancouver B2型股骨假体周围骨折锁定板或皮质骨板不同内固定方式的生物力学分析. 中国组织工程研究, 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, 张舜, 张传林, 等. 股骨环抱器记忆合金治疗Vancouver B1型股骨假体周围骨折的临床效果. 医药论坛杂志, 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, 李飞, 等. 老年髋关节术后发生假体周围骨折的危险因素研究. 创伤外科杂志, 2021, 23(10): 740-743, 748.
11. 索海强. 人工髋关节置换术后股骨假体周围骨折的治疗及疗效分析. 长春: 吉林大学, 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. 鹿战, 刘沛东, 史俊龙, 等. 髋关节置换术假体周围骨折危险因素的Meta分析. 中国骨伤, 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. 康鹏德, 李东海, 裴福兴. 全髋关节置换术后股骨假体周围骨折的治疗策略. 中华骨科杂志, 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. 张斌. 记忆合金环抱器在四肢骨折中的应用. 中国医药导报, 2010, 7(20): 39, 42.
19. 胡智, 戴天阳. 镍钛记忆合金环抱器治疗多发性肋骨骨折的临床研究. 重庆医学, 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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