Osteosynthesis using ultra-high molecular weight polyethylene fiber cables for periprosthetic femoral fracture.

Background: An ultra-high molecular weight polyethylene (UHMWPE) fiber cable, formed into a soft flexible tape, offers excellent properties for use in osteosynthesis. The purpose of this study was to evaluate the outcomes of osteosynthesis using the UHMWPE fiber cable.

Methods: In this study, 23 patients who underwent osteosynthesis with the use of a UHMWPE fiber cable for periprosthetic fracture (PPF) following total or bipolar hip arthroplasty, at a total of 56 sites, were retrospectively evaluated. The procedures were performed between August 2010 and December 2022. The mean duration of clinical follow-up was 4.1 years (range, 1-10). The cable was used in two ways: direct cerclage around the femur at 38 sites and indirect cerclage around the femur through contact with a metal plate and/or strut grafts at 18 sites.

Results: No clinical complications were observed after the use of UHMWPE fiber cables. Fracture union was confirmed in all cases, with a mean duration of 7.6 months (range, 2-21). Local bone atrophy was observed in 27 % (15/56 sites), with a mean occurrence of 0.9 years (range, 0.1-2.9), but this atrophy did not progress. Significantly less bone atrophy was noted at the greater trochanter than at the femoral shaft (P = 0.009). The atrophy incidence rate was 39 % (15/38 sites) for direct cerclage and 0 % for indirect cerclage (P = 0.0009).

Conclusion: Osteosynthesis using a UHMWPE fiber cable for PPFs yielded successful results and was especially useful for reduction and fixation around the greater trochanter. However, for direct cerclage at the femoral shaft, particular attention to strategies that can prevent local bone atrophy is required.