Recon Classifications

Question 1

Vancouver

Answer 1

A Fracture in trochanteric region Commonly associated with osteolysis and often requires treatment that addresses the osteolysis. Consider ORIF in displaced fractures.

B1 Fracture around stem or just below it with a well fixed stem ORIF using cerclage cables and locking plates

B2 Fracture around stem or just below it, loose stem, but good proximal bone stock Revision of the femoral component to a long porous-coated cementless stems and fixation of the fracture fragment. Revision of the acetabular component if indicate

B3 Fracture around stem or just below with proximal bone that is poor quality or severely comminuted Femoral component revision with proximal femoral allograft or proximal femoral replacement

C Fracture occurs well below the prosthesis ORIF with plate
- leave the hip and acetabular prosthesis alone

Question 2

Paprosky Classification of Acetabular Bone Loss

Answer 2

Type I
Minimal deformity, intact rim
Type IIA Superior bone lysis with intact superior rim
Type IIB Absent superior rim, superolateral migration
Type IIC Localized destruction of medial wall
Type IIIA Bone loss from 10am-2pm around rim, superolateral cup migration
Type IIIB
Bone loss from 9am-5pm around rim, superomedial cup migration

Question 3

Paprosky Classification of Femoral Bone Loss

Answer 3

Type I Minimal metaphyseal bone loss
Type II Extensive metaphyseal bone loss with intact diaphysis
Type IIIa Extensive metadiaphyseal bone loss, minimum of 4 cm of intact cortical bone in the diaphysis
Type IIIb Extensive metadiaphyseal bone loss, less than 4 cm of intact cortical bone in the diaphysis
Type IV Extensive metadiaphyseal bone loss and a nonsupportive diaphysis

Question 4

AVN - Steinberg Classification (modification of Ficat classification)

Answer 4

Stage
Radiographs
MRI
Images
0 normal normal MRI and bone scan
I normal abnormal MRI and/or bone scan
II cystic or sclerosis changes abnormal MRI and/or bone scan
III crescent sign (subchondral collapse) abnormal MRI and/or bone scan
IV flattening of femoral head abnormal MRI and/or bone scan
V narrowing of joint abnormal MRI and/or bone scan
VI advanced degenerative changes abnormal MRI and/or bone scan

Question 5

Revision Total Knee Classification

Answer 5

Anderson Orthopaedic Research Institute (AORI) Classification
Type
Description
Treatment
Type 1 Minor bone defects with intact metaphyseal bone that do not compromise stability Cement fill or impaction allograft
Type 2A Metaphyseal bone damage that involves 1 femoral condyle or tibial plateau
Cement fill, augments, small bone graft
Type 2B Metaphyseal bone damage that involves both femoral condyles or tibial plateaus
Cement fill, augments, small bone graft
Type 3 Massive bone loss comprising a large portion of condyle/plateau, and can involve the collateral ligaments/patellar tendon
Bulk allografts, custom implants, megaprosthesis, porous tantalum, metaphyseal sleeves, rotating hinge

Question 6

Periprosthetic Knee #

Answer 6

Lewis and Rorabeck Classification (1997)
Type I Nondisplaced; component intact
Type II Displaced: component intact
Type III Displaced; component loose or failing