B2 or not B2? That is the question: a review of periprosthetic fractures around cemented taper-slip femoral components

Aims Periprosthetic fractures (PPFs) around cemented taper-slip femoral prostheses often result in a component that is loose at the prosthesis-cement interface, but where cement-bone interface remains well-fixed and bone stock good. We aim to understand how best classify manage these by using modification of Vancouver classification. Methods reviewed 87 PPFs. Each was first episode fracture component, surgical management consisted revision surgery. Data regarding initial injury, intraoperative findings, were prospectively collected. Patient records serial radiographs determine classification, whether cement well fixed (B2W) or (B2L), time union following treatment. Results In total, 47 B2W (54.0%) one B3 (1.1%) had remained interface. These cases treated with cement-in-cement (CinC) arthroplasty. Overall, 43 follow-up united, two patients sustained further secondary nonunion required A total 19 B2L (21.8%) managed arthroplasty either uncemented components, proximal One case could not be classified. Conclusion endorse original system include subclassification B2 (where bone) loose). Fractures design stems are more likely pattern compared composite beam which pattern. can reliably CinC revision. Cite this article: Bone Joint J 2021;103-B(1):71–78.