Clinical outcomes of revision arthroplasty with a modular taper fluted titanium stem for the treatment of Vancouver B2 and B3 periprosthetic femur fractures

Background: Existing literature on Vancouver B2 and B3 periprosthetic fracture management with modular tapered fluted stems (MTFS) is limited by lack of patient-reported outcomes, small samples, and unseparated inclusion of multiple implant models. This study examines the outcomes of Vancouver B2 and B3 fractures treated with a single MTFS hip system, the Zimmer Modular Revision (ZMR), with a minimum 1-year follow-up. Methods: We conducted a retrospective review of all patients who received a femoral revision with a ZMR taper stem to treat a Vancouver B2 or B3 fracture at our centre between 2006 and 2020. The primary outcome was all-cause reoperation, with secondary outcomes including the Harris Hip Score (HHS), the Oxford Hip Score (OHS), stem subsidence, and mortality. Results: We included 44 patients (mean age 71.6 yr) in the final analysis, with a mean follow-up of 50.2 months. The all-cause reoperation rate was 11.9% (n = 5). Although there were 3 cases (7.1%) of stem subsidence, there were no cases in which stem revision was required. The mean HHS was 77.2 (standard deviation [SD] 10.6, range 47 to 91) and the mean OHS was 42.5 (SD 5.2, range 33 to 48). Conclusion: Management of Vancouver B2 and B3 periprosthetic femur fractures with the ZMR MFTS option resulted in an acceptable complication profile and good functional outcome with a minimum 1-year follow-up.