Trauma | September 2021

The new Variable Angle LCP ® Periprosthetic Proximal Femur System

Karl Stoffel, Mark Lee, Cong-Feng Luo, Rodrigo Pesantez, Christopher Finkemeier, George Haidukewych, Frank Liporace, Cory Collinge, Bruce Ziran, Christoph Sommer


The number of periprosthetic femoral fractures (PPFs) is expected to rise due to the expanded use of total hip arthroplasties (THAs) in the growing population of elderly and more active patients. Most PPFs with a stable prosthesis are eligible for treatment with open reduction and internal fixation (ORIF). However, ORIF can be challenging because patients often have diminished bone quality and the physical presence of the hip prosthesis may obstruct adequate proximal fixation. Furthermore, there are concerns that stress risers at the end of a fixation construct may lead to refracture of the femur. A strategy to avoid this potential complication is to protect the femur with a femoral-spanning osteosynthesis.

The new Variable Angle LCP Periprosthetic Proximal Femur Plating System (Fig 1 and Fig 2) was developed to address these aspects. It was specifically designed to meet the following requirements in the treatment of Vancouver types A and B fractures:

  • Modular implant configuration to address a wide variety of PFFs.

  • Implant system with many fixation options to achieve high osteosynthesis stability in poor bone quality.

  • Implant design to facilitate fracture fixation in presence of THAs and other intramedullary implants (eg, short proximal nails).

  • Soft tissue friendly solution that minimizes damage to the blood supply.

  • Implant that allows to span and protect the whole femur.

The modular system consists of anatomically pre-shaped plates with variable angle locking screw technology. The versatility of the system allows the surgeon to connect the plate components in various configurations in response to different fracture patterns. The number of plate holes and their location were chosen to facilitate high fixation density around an intramedullary implant. The distal spanning attachment plate is intended to prevent fractures of the intact distal femur rather than span a fracture. It is designed to avoid abrupt stiffness changes in the fixation construct by distributing the load among multiple fixation points in the lateral femoral condyle.

Fig 1 The Proximal Femur Plate and the Proximal Femur Hook Plate are the two main plates of the 3.5/4.5 Variable Angle LCP Periprosthetic Proximal Femur Plating System. The Greater Trochanter (GT) Ring Attachment Plate, VA Locking Attachment Plate and Distal Femur Spanning Attachment Plate can be assembled to the two main plates with threaded inserts and upper screws. A dedicated GT Hook Plate without plate shaft is available as stand-alone device for fixation of simple Vancouver type AG fractures  fractures as well as greater trochanter osteotomies. The availability of the individual plates is dependent on the region-specific medical device regulations. In Europe the system is launched without the GT Hook Plate, GT Ring Attachment Plate and Distal Femur Spanning Attachment Plate which will be made available at a later date.




Fig 2 The 3.5/4.5 Variable Angle LCP Periprosthetic Proximal Femur Plating System is offered in stainless steel. The plate configuration shown: Proximal Femur Plate with GT Ring Attachment Plate, VA Locking Attachment Plate, and Distal Femur Spanning Attachment Plate.



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