Short-term results and review of the literature after femoral fractures in patients with total hip replacements

ISRCTN ISRCTN67843945
DOI https://doi.org/10.1186/ISRCTN67843945
Secondary identifying numbers 621/2015BO2
Submission date
19/11/2019
Registration date
14/01/2020
Last edited
05/08/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Periprosthetic fractures (Vancouver type B2/B3) after total hip arthroplasty (hip replacement) are an increasing and challenging problem. Only limited evidence is available for this type of fracture treated with modular stems. Therefore, this study evaluated the outcome of Vancouver type B2/B3 fractures treated with a modular hip revision stem using a subproximal/distal anchorage and compared it with the current literature.

Who can participate?
Patients with Vancouver B2 and B3 fractures recorded between 2013 and 2016 and treated with a cementless, modular, fluted, tapered revision stem (Prevision®, B. Braun Aesculap AG, Tuttlingen, Germany)

What does the study involve?
The clinical and radiographic outcomes of patients with femoral fractures around their total hip replacements are evaluated after surgical treatment. Furthermore, complications are evaluated as well. The study involves a clinical examination as well as scores and regular x-rays of the affected hip.

What are the possible benefits and risks of participating?
There are no risks in participating as the follow-up is similar to a regular follow-up in clinic with the benefit of informing the patient and treating possible complications.

Where is the study run from?
Eberhard Karls University Tübingen (Germany)

When is the study starting and how long is it expected to run for?
October 2015 to December 2018

Who is funding the study?
B. Braun, Aesculap

Who is the main contact?
Dr Florian Schmidutz
fschmidutz@bgu-tuebingen.de

Contact information

Dr Florian Schmidutz
Public

Schnarrenbergstr. 95
Tübingen
72076
Germany

Phone +49 (0)7071 6063803
Email fschmidutz@bgu-tuebingen.de

Study information

Study designA consecutive series of periprosthetic Vancouver type B2/B3 fractures treated with a modular revision stem via a modified transfemoral approach was retrospectively (2013-2016) evaluated (observational study).
Primary study designObservational
Secondary study designCase series
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format. Please use contact details to request a participant information sheet.
Scientific titleHip revision arthroplasty of periprosthetic fractures Vancouver B2 and B3 with a modular revision stem: short-term results and review of literature
Study acronymPrevision
Study objectivesPeriprosthetic Vancouver type B2 and B3 fractures are challenging to treat and there is no consent about the stem design and technique. Furthermore, there is only limited number of studies with moderate number of cases for fractures Vancouver type B2 and B3.

The researchers therefore analyzed the outcome of Vancouver B2 and B3 fractures using a cementless, modular revision stem with a subproximal and distal fixation using a modified transfemoral approach. The aim was to show that the modular revision stem inserted via a transfemoral approach would lead to good or at least comparable results in terms to fracture healing, fixation of the stem, subsidence and functional outcome compared to stems with proximal fixation and the current literature.
Ethics approval(s)Approved 01/10/2015 by the local ethics committee at the Faculty of Medicine at the Eberhard Karls University and the Medical Center, Tübingen (Gartenstrasse 47, 72074 Tübingen, Germany; Tel: +49 (0)7071 29-77661; Email: ethik.kommission@med.uni-tuebingen.de), ref: 621/2015BO2
Health condition(s) or problem(s) studiedOrthopaedic surgery: Vancouver B2/3 periprosthetic fractures
InterventionA consecutive series of periprosthetic Vancouver type B2/B3 fractures treated with a modular revision stem via a modified transfemoral approach was retrospectively (2013-2016) evaluated. The assessment included the clinical (HHS, pain, ROM) as well as the radiological outcome (subsidence, loosening, fracture healing).
Intervention typeProcedure/Surgery
Primary outcome measureClinical and radiological outcome, measured using the Harris Hip Score and a regular clinical examination comprising palpation of the site as well as evaluation of ROM (range of motion) and standardized radiographs of the affected hip in two planes at the time of the patients' individual postoperative follow-up
Secondary outcome measuresComplications, measured by analyzing clinical and radiological outcome combined with data from the digital clinical information charts regarding subsequent surgeries as well as any kind of complication occurred for the duration of the study
Overall study start date01/10/2015
Completion date31/12/2018

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsRetrospectively analyzed case series of all available cases as defined above (18)
Total final enrolment18
Key inclusion criteriaAll consecutive Vancouver B2 and B3 fractures that were recorded between 2013 and 2016 and treated with a cementless, modular, fluted, tapered revision stem (Prevision®, B. Braun Aesculap AG, Tuttlingen, Germany) were included and retrospectively analyzed. The patients who could be contacted were examined clinically and radiologically within the study.
Key exclusion criteria1. Insufficient data or follow-up at less than 3 months
2. Patients who suffered from dementia
3. Insufficient knowledge of the study language
4. incapable of participating in the study due to severe health conditions
Date of first enrolment01/01/2016
Date of final enrolment31/12/2017

Locations

Countries of recruitment

  • Germany

Study participating centre

BG Trauma Center Tübingen,
Department of Arthroplasty
Eberhard Karls University Tübingen
Schnarrenbergstrasse 95
Tübingen
72076
Germany

Sponsor information

BG Trauma Center Tübingen
Hospital/treatment centre

Schnarrenbergst. 95
Tübingen
72076
Germany

Phone +49 (0)7071 6063803
Email fschmidutz@bgu-tuebingen.de
Website http://www.bgu-tuebingen.de/
ROR logo "ROR" https://ror.org/04wwp6r22

Funders

Funder type

Industry

B. Braun, Aesculap

No information available

Results and Publications

Intention to publish date31/07/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe researchers plan to submit the paper to "Orthopedics".

Added 15/05/2020:
The paper has been re-submitted to another journal and is under review.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Dr Florian Schmidutz (fschmidutz@bgu-tuebingen.de) and Dr Anna J. Schreiner (annajschreiner@yahoo.de). The data comprises Excel spreadsheets, consent from participants was obtained.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 03/08/2020 05/08/2021 Yes No

Editorial Notes

05/08/2021: Publication reference added.
15/05/2020: The publication and dissemination plan was updated and the intention to publish date was changed from 22/11/2019 to 31/07/2020.
05/12/2019: Trial's existence confirmed by local ethics committee at the Faculty of Medicine at the Eberhard Karls University and the Medical Center, Tübingen.