Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures.

Fractures around a femoral prosthesis have been treated with plating and additional cement, but this leads to further reduction of bone stock in the proximal femur. Since February 1992, we have dealt with this problem in 12 patients by revision using a long uncemented stem and distal interlocking combined with homologous bone grafting. Bony ingrowth and remodelling led to restoration of the proximal femur. After bone healing, removal of the distal interlocking screws converts the distal load transfer to the proximal anchoring of the revision stem so that osteointegration can occur in the trochanteric region. The clinical results were good in all the patients after a mean follow up of 23.5 months. This is a method which provides biological osteosynthesis and is especially indicated in younger patients.