Periprosthetic Hip Fractures

One of the most challenging complications after total hip arthroplasty (THA) is periprosthetic fracture (PPF), presenting a significant clinical and economic burden. The UCS should be routinely used to classify and describe PPFs. However, physicians should also consider different parameters such as the patient’s comorbidities, type of stem, and infectious status. Commonly, a multidisciplinary approach with experienced arthroplasty and trauma surgeons is necessary to treat these types of fractures promptly. Thorough preoperative planning is required to treat these complex fractures. The majority of PPF are treated surgically. The goal of the surgical treatment is to restore the normal alignment, provide a stable construct, preserve bone stock, facilitate bone healing, allow normal range of motion, and enhance early mobilisation. The surgical technique and type of implant are influenced by the fracture pattern, the stability of the components, and the amount of bone stock. Surgical treatment may be revision only, revision with open reduction and internal fixation (ORIF), or ORIF only. Managing PPFs within high specialised volume centres would improve patient care and reduce complication and failure rates and overall health costs. Scarce evidence is available regarding functional outcomes and implant survivorship following revision arthroplasty secondary to PPFs. The short follow-up in most studies and the high mortality rate of the involved patient population might influence the availability of long-term evidence.