[Evaluation of the results of the treatment of Vancouver B1 XXXX and proposed indications for the use of cortical allograft as part of the fixation].

@entity1 @entity174 @entity397 @entity3918 @entity3564
Currently there is limited information on the indications for the use of cortical allograft for the treatment of @entity3564 on a stable stem. The purpose of this study was to retrospectively evaluate the treatment and the results obtained in this type of @entity174 and propose a series of criteria for the use of cortical allograft. Between 2003 and 2008 a total of 31 periprosthetic femur @entity174 were treated at our institution. Twelve of them were classified as B1: 6 were treated with a Dall-Miles (Stryker) system plate and 6 with the same plate supplemented with a structural cortical allograft over the medial cortex of the femur ( @entity3918 and @entity3918 -Allo groups, respectively). An evaluation of the clinical and radiologic results was performed in the latest follow-up available. A @entity1 in the @entity3918 -Allo group had @entity397 of a screw and 10 degrees varization; the @entity174 healed despite this and the @entity1 had a satisfactory clinical course. The Oxford Hip Score was 9 points lower in the @entity3918 group compared with the @entity3918 -Allo group, and the EQ-5D health scale was 0.10 better for the @entity3918 group. The @entity3918 -Allo group had a longer hospital stay and more transfusion-related requirements. We think that the @entity1 with clinical or radiologic criteria of osteoporotic bone may benefit from the use of a cortical allograft to favor healing and increase the bone stock. However, those advantages should be weighed considering the higher risk of surgical-related morbidity associated with the surgical insult.
