Management of Vancouver B2 and B3 Periprosthetic Proximal Femoral Fractures by Distal Locking Femoral Stem (Cannulok) in Patients 75 Years and Older

J Arthroplasty. 2017 Feb;32(2):541-545. doi: 10.1016/j.arth.2016.07.022. Epub 2016 Aug 12.


Background: Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge.

Methods: We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery.

Results: The mean follow-up was 44.6 months (range, 24-102). The mean postoperative Oxford hip score was 30.1 (range, 10-46). The rate of fracture union was 95.8%, and the survivorship of the stem was 100% at the end of follow-up.

Conclusion: The management of PFF in elderly is associated with increased postoperative morbidity and mortality. The use of a distally locked, hydroxyapatite-coated femoral stem is a valid option for the treatment of PFF to achieve fracture union with a low rate of revision.

Keywords: Cannulok; distally locked stem; elderly; periprosthetic femoral fractures; revision hip arthroplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Durapatite
  • Female
  • Femoral Fractures
  • Femur / surgery
  • Hip Fractures / etiology
  • Hip Fractures / surgery*
  • Hip Prosthesis*
  • Humans
  • Male
  • Periprosthetic Fractures / etiology
  • Periprosthetic Fractures / surgery*
  • Postoperative Period
  • Reoperation
  • Retrospective Studies


  • Durapatite