关键词: 髋关节置换；翻修；假体周围骨折；骨移植；股骨

Abstract:

Objective   To analyze the therapeutic effect of  Vancouver type B3 periprosthetic femoral fracture after treating with greater trochanter reattachment device (GTR) and cortical strut bone graft in the prosthesis revision of the total hip arthroplasty.  Methods   A total of 26 patients were selected from January 2006 to January 2011, including 5 males and 21 females, aged 55~79 years, 63.52 years on average. All the cases were treated by the Zimmer greater trochanter reattachment device (GTR), and the Zimmer Wagner uncemented long stem. Harris score was used to evaluate the hip functions before and after the operation.  Prosthesis stability and the bony union were assessed by the digital radiography.  Results   All the patients were followed-up for 25 months on average (12~35 months) after the operation. All the fractures reached union, and there was no infection, stem loosening, nonunion and malunion. The Harris score was (35.26±3.35) before the operation, which was improved to (84.70±6.21) after the operation, and the good-to-excellent rate was 80.77% (5 excellent cases, 16 good  cases and 5 average cases). X-ray showed that the prosthesis was stable, and the host bone and bone graft achieved bony union. Conclusion   The prosthesis revision of the total hip arthroplasty with the greater trochanter reattachment device (GTR) and cortical strut bone graft used for the Vancouver type B3 periprosthetic proximal femur fractures has the advantages of simple manipulation, less complications, good recovery of the hip function and satisfactory results in the short period.

Key words: Hip arthroplasty; Revision; Periprosthetic fracture; Bone graft; Femur