Long stem cemented revision arthroplasty offers shorter time to bone union and independent cane walking for periprosthetic femoral fracture

Background: There have been few reports of long stem cemented revision arthroplasty in the treatment of periprosthetic fractures (PPFs). The purpose of this study was to retrospectively compare the clinical and radiological outcomes between osteosynthesis and long stem cemented revision arthroplasty for PPFs. Methods: This study retrospectively evaluated 29 femurs who underwent surgical treatment for PPF following total or bipolar hip arthroplasty. The mean duration of clinical follow-up was 5.0 (range 2–12) years. Surgical options included osteosynthesis only in 7 femurs (Group O) and long stem cemented revision arthroplasty in 22 femurs (Group R). Results: Repeat surgeries due to implant failure were performed in 2 (29%) and 1 (5%) in groups O and R, respectively. In the walking component of the mean Merle d'Aubigné clinical score at the last follow-up, there were significant differences between the groups. Mean time to independent cane walking was 24.0 (13.1−42.3) weeks and 7.2 (2.0−15.6) weeks in groups O and R, respectively (p < 0.05). Bone union rates were 71% and 95% in groups O and R, respectively (p = 0.14). Where bone union was successfully achieved, the mean time to bone union was 12.2 (6.1−22.2) months in group O and 6.6 (1.7−12.5) months in group R (p < 0.05). Conclusions: The time to independent cane walking and bone union was significantly shorter for long stem cemented revision arthroplasty. This procedure offers considerable advantages for patients, despite the difficulty of the procedure for surgeons.