ArticleArchives of orthopaedic and trauma surgery2022
Vancouver B and C periprosthetic fractures around the cemented Exeter Stem: sex is associate with fracture pattern.
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Stem revision vs. internal fixation in Vancouver B2/B3 periprosthetic hip fractures: systematic review and metanalysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- MIPPO Combined With NCB.PP for Treating Vancouver Type B Femoral Periprosthetic Fractures.Orthopaedic surgery · 2026Article
- Risk Factors and Predictors of 1-Year Mortality in 262 Vancouver Type C Periprosthetic Femoral Fractures: Insights from the PIPPAS Prospective Multicenter Observational Study.Journal of clinical medicine · 2025Article
- Fixation versus revision arthroplasty for Unified Classification System type B periprosthetic fractures around cemented polished tapered femoral components : a systematic review and meta-analysis.Bone & joint open · 2025Article
- Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study).Arthroplasty today · 2025Article
- Periprosthetic Fracture After Cementless Revision Total Hip Arthroplasty with a Tapered, Fluted Monobloc Stem: A Retrospective Long-Term Analysis of 121 Cases.Journal of clinical medicine · 2025Article
- Periprosthetic Femoral Fractures-Beyond B2.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Review
- Outcomes of Exeter cemented total hip arthroplasty in a county hospital: survivorship of eight hundred and ninety four hips with a minimum ten-year follow up.International orthopaedics · 2024Article
- Fracture pattern and risk factors for reoperation after treatment of 156 periprosthetic fractures around an anatomic cemented hip stem.Acta orthopaedica · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this study was to identify factors associated with the level of periprosthetic fracture involving a cemented polished tapered stem: Vancouver B or Vancouver C.
methodsA retrospective cohort study of 181 unilateral periprosthetic fractures involving Exeter stems was assessed by three observers (mean age 78.5, range 39-103; mean BMI 27.1, 17-39; 97 (54%) male). Patient demographics, deprivation scores, BMI and time since primary prosthesis were recorded. Femoral diameter, femoral cortical thickness, Dorr classification and distal cement mantle length were measured from calibrated radiographs. Interobserver reliability was calculated using intraclass correlation coefficients (ICCs). Univariate and multivariate analysis was performed to identify associations with Vancouver B or C fractures.
results160/181 (88%) Vancouver B and 21/181 (12%) Vancouver C-level fractures occurred at a mean of 5.9 ± 5.4 years (0.2-26.5) following primary surgery. Radiographic measurements demonstrated excellent agreement (ICC > 0.8, p < 0.001). Mortality was significantly higher following Vancouver C compared to B fractures: 90 day 14/160 Vs 5/21 (p = 0.05); 1 year 29/160 Vs 8/21 (p = 0.03). Univariate analysis demonstrated that Vancouver C fractures were associated with female sex, bisphosphonate use, cortical bone thickness, and distal cement mantle length (p < 0.05). On multivariate analysis, only female sex was an independent predictor of Vancouver C-level fractures (R
conclusionMost PFFs involving the Exeter stem design are Vancouver B-type fractures and appear to be independent of osteoporosis. In contrast, Vancouver C periprosthetic fractures display typical fragility fracture characteristics and are associated with female sex, thinner femoral cortices, longer distal cement mantles and high mortality.
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