{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T21:00:54Z","timestamp":1784840454948,"version":"3.55.0"},"reference-count":16,"publisher":"Begell House","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Long Term Eff Med Implants"],"published-print":{"date-parts":[[2026]]},"abstract":"<p>Periprosthetic femoral fractures after total hip arthroplasty (THA) are increasing, though Vancouver type B3 fractures-characterized by a loose femoral stem and poor bone stock-are generally considered unsuitable for conservative treatment. We report a rare case of successful conservative management in a 79\u2011year\u2011old woman who sustained a Vancouver type B3 fracture 12 years after conversion of hip arthrodesis to THA. Severe cardiac dysfunction (ejection fraction 30&amp;#37;) precluded surgical intervention, and long\u2011term non\u2011weight bearing with physiotherapy was adopted. After 20 months, the patient wished to regain independent ambulation, and a carefully monitored rehabilitation program with gradual weight bearing was initiated. Muscle strength improved steadily, and radiographs confirmed fracture union and stem stability. Ultimately, the patient regained the ability to walk independently with a pick\u2011up walker. This case highlights that, although extremely rare, conservative treatment combined with sustained exercise therapy may achieve favorable outcomes in selected patients with Vancouver type B3 fractures when surgery is contraindicated.<\/p>","DOI":"10.1615\/jlongtermeffmedimplants.2026062716","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T17:31:33Z","timestamp":1770053493000},"page":"23-27","source":"Crossref","is-referenced-by-count":0,"title":["Successful Conservative Treatment for Vancouver Type B3 Periprosthetic Femoral Fracture after Total Hip Arthroplasty: A Case Report"],"prefix":"10.1615","volume":"36","author":[{"given":"Yusuke","family":"Yamauchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Sekita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kusaba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"613","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"Bischel OE, Jung MK, Suda AJ, Seeger JB, B\u00f6hm PM. Epidemiology of periprosthetic fractures after cementless revision total hip arthroplasty with tapered, fluted stems at mid-to long-term follow-up. J Clin Med. 2025;14(5):1468.","DOI":"10.3390\/jcm14051468"},{"key":"2","doi-asserted-by":"crossref","unstructured":"Luger M, Gotterbarm T, Schopper C. Periprosthetic fracture in hip replacement-\u0080\u0094Risk factors and treatment. Orthop\u00e4die. 2025;54(5):522-\u0080\u00939 (in German).","DOI":"10.1007\/s00132-025-04658-z"},{"key":"3","doi-asserted-by":"crossref","unstructured":"Lamb JN, Evans JT, Relton S, Whitehouse MR, Wilkinson JM, Pandit H. The incidence of postoperative periprosthetic femoral fracture following total hip replacement: An analysis of UK National Joint Registry and Hospital Episodes Statistics data. PLoS Med. 2024;21(10):e1004462.","DOI":"10.1371\/journal.pmed.1004462"},{"key":"4","doi-asserted-by":"crossref","unstructured":"Takami H, Takegami Y, Tokutake K, Kurokawa H, Iwata M, Terasawa S, Oguchi T, Imagama S. Mortality and clinical outcomes of Vancouver type B periprosthetic femoral fractures: A multicentre retrospective study. Bone Jt Open. 2022;3(4):263-\u0080\u009371.","DOI":"10.1302\/2633-1462.41.BJO-2022-0145.R1"},{"key":"5","doi-asserted-by":"crossref","unstructured":"Axenhus M, Mukka S, Magn\u00e9li M, Sk\u00f6ldenberg O. Comparative outcomes of uncemented and cemented stem revision in managing periprosthetic femoral fractures: A retrospective cohort study. J Orthop Traumatol. 2024;25(1):35.","DOI":"10.1186\/s10195-024-00777-z"},{"key":"6","doi-asserted-by":"crossref","unstructured":"Montalti M, Pilla F, Guerra G, Traina F. Periprosthetic femoral fractures: Treatments and outcomes. An analysis of 47 cases. Hip Int. 2013;23(4):380.","DOI":"10.5301\/hipint.5000025"},{"key":"7","unstructured":"De Maio F, Caterini A, Cesaretti L, Ziranu A, De Luna V, Farsetti P. Vancouver B2 and B3 periprosthetic femoral fractures treated by ORIF: Mid- to long-term follow-up study in 28 patients. Eur Rev Med Pharmacol Sci. 2022;26(1 Suppl):1-\u0080\u00938."},{"key":"8","doi-asserted-by":"crossref","unstructured":"Barghi A, Hanna P, Merchan N, Weaver MJ, Wixted J, Appleton P, Rodriguez E. Outcomes of fixation of Vancouver B periprosthetic fractures around cemented versus uncemented stems. BMC Musculoskelet Disord. 2023;24(1):263.","DOI":"10.1186\/s12891-023-06359-0"},{"key":"9","doi-asserted-by":"crossref","unstructured":"Hakuta N, Katsui M, Tsuchida M, Yamaoka K, Kusaba A, Kondo S, Kuroki Y. Common femoral artery initial injury following total hip replacement for an arthrodesed hip. Showa Univ J Med Sci. 2012;25:243-\u0080\u00938.","DOI":"10.15369\/sujms.23.243"},{"key":"10","doi-asserted-by":"crossref","unstructured":"Lerman BJ, Popat RA, Assimes TL, Heidenreich PA, Wren SM. Association of left ventricular ejection fraction and symptoms with mortality after elective noncardiac surgery among patients with heart failure. JAMA. 2019;321(6):572-\u0080\u00939.","DOI":"10.1001\/jama.2019.0156"},{"key":"11","doi-asserted-by":"crossref","unstructured":"Joshi AB, Markovic L, Hardinge K, Murphy JC. Conversion of fused hips to total hip arthroplasty. J Bone Joint Surg Br. 2002;84(1):133-\u0080\u00939.","DOI":"10.2106\/00004623-200208000-00008"},{"key":"12","doi-asserted-by":"crossref","unstructured":"Villanueva M, Sobr\u00f3n FB, Parra J, Rojo JM, Chana F, Vaquero J. Conversion of arthrodesis to total hip arthroplasty: Clinical outcome, complications, and prognostic factors of 21 consecutive cases. HSS J. 2013;9(2):123-\u0080\u00939.","DOI":"10.1007\/s11420-013-9330-3"},{"key":"13","unstructured":"Schmotzer H, Clausen JD. Primary stability-The first step in successful cementless total hip replacement. In: Friederich N, Santos RF, editors. 25 Years of Biologic Fixation K. Zweym\u00fcller. M\u00fcnchen, Jena, Germany: Elsevier GmbH, Urban & Fischer Verlag; 2007. p. 113-\u0080\u00938."},{"key":"14","doi-asserted-by":"crossref","unstructured":"Uriarte I, Moreta J, Cort\u00e9s L, Bernuy L, Aguirre U, Mart\u00ednez de los Mozos JL. Revision hip arthroplasty with a rectangular tapered cementless stem: A retrospective study of the SLR-Plus stem at a mean follow-up of 4.1 years. Eur J Orthop Surg Traumatol. 2020;30(2):281-\u0080\u00939.","DOI":"10.1007\/s00590-019-02578-1"},{"key":"15","unstructured":"Lintner F, B\u00f6hm G, Huber M, Obenaus Ch, Zweym\u00fcller K. Stem in pathological anatomical specimens. In: Friederich N, Santos RF, editors. 25 Years of Biologic Fixation K. Zweym\u00fcller. M\u00fcnchen, Jena, Germany: Elsevier GmbH, Urban & Fischer Verlag; 2007. p. 131-\u0080\u00938."},{"key":"16","doi-asserted-by":"crossref","unstructured":"Wright C, Lambert D, Brazil D, Keggi K, Keggi J, Mc-Tighe T. Clinical review of the Zweymuller femoral stem. Reconstr Rev. 2011;1(1):5.","DOI":"10.15438\/rr.v1i1.5"}],"container-title":["Journal of Long-Term Effects of Medical Implants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.dl.begellhouse.com\/download\/article\/7366d716377bfab3\/JLT-62716.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:04:53Z","timestamp":1784837093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.dl.begellhouse.com\/journals\/1bef42082d7a0fdf,23fd70422a5de2ce,7366d716377bfab3.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1615\/jlongtermeffmedimplants.2026062716","relation":{},"ISSN":["1050-6934"],"issn-type":[{"value":"1050-6934","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]}}}