2026 AAHKS Annual Meeting: Equivalent Outcomes with Stability Matched ORIF vs. Revision Arthroplasty for Vancouver B Fractures

87 patients with Vancouver B periprosthetic femoral fractures were retrospectively evaluated following open reduction and internal fixation (ORIF) with femoral stem retention (n=42) or revision arthroplasty (n=45). The primary outcomes were reoperation-free and revision-free survivorship. Secondary outcomes included operative time, blood loss, transfusion requirements, dislocation, infection, nonunion, mortality, and the accuracy of preoperative stem stability assessment. Outcomes were assessed at a minimum of 90 days, with a median follow-up of 364 days. Overall, the results revealed comparable reoperation-free and revision-free survivorship between ORIF and revision arthroplasty when treatment was appropriately matched to femoral stem stability. However, revision arthroplasty required greater operative time, blood loss, and transfusion support. These findings suggested that stability-based treatment selection provided similar early clinical outcomes while avoiding unnecessary revision surgery in patients with well-fixed stems.