Clinical and Biomechanical Assessment of the Treatment of Type B Periprosthetic Fractures of the Femur

Declaration I hereby declare that this dissertation is the result of my own work and includes nothing which is the outcome of work done in collaboration except where is specifically indicated in the text and bibliography and that my thesis is not substantially the same as any that I have submitted for a degree of diploma or other qualification at any other University. In addition, this dissertation falls within the word limit of exclusive of tables, footnotes, bibliography, and appendices, as set by the University College London. Abstract Total hip arthroplasty is a well established treatment modality for the diseased hip. The number implanted rises annually on a global scale which is mirrored by increasing indications. After aseptic loosening and infection, periprosthetic fracture remains one of the commonest complications of this otherwise successful surgery. Management is geared towards restoring function through fixation of the fracture. The general aim of this thesis is to validate the classification of periprosthetic fractures of the femur around total hip arthroplasty, provide evidence towards the outcomes of methods of fixation of these fractures, and present supplementary biomechanical data regarding fixation and implant stress. It is hypothesised that the Vancouver classification will be a reliable and reproducible system to use, that strut grafts, cables and long-stemmed implants will improve function and outcome when used to manage these injuries, and that biomechanical models will provide evidence on why the use of the implants is successful.