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.