Management of Vancouver B2 peri-prosthetic femoral fractures: following the evidence

This study by Shi (1) is one in a series of studies that have demonstrated the effectiveness of long-stem revision arthroplasty supplemented with cerclage for the management of Vancouver B2 peri-prosthetic femur fractures after total hip arthroplasty (THA). No randomized trials exist addressing the optimal management of such fractures; instead, management guidelines have been developed based upon accumulation of level IV evidence. This study reported the outcomes of 14 patients after a mean of 5.2 years. All patients had clinical and radiological fracture union within 6.5 months and no adverse events were reported. A mean Harris hip score of 83 points is above what has been typically reported for revision THA (2).