Periprosthetic Fractures of the Femur After Total Hip Arthroplasty

Abstract

The incidence of periprosthetic fracture of the femur associated with total hip arthroplasty is increasing. These fractures can occur following surgery or intraoperatively, and are associated with substantial morbidity and mortality. Among the risk factors for periprosthetic fracture of the femur after total hip arthroplasty are diminished bone strength, older age, osteoporosis, rheumatoid arthritis, inflammatory arthropathies, female gender, and revision surgery. Although several systems exist for classifying such fractures, the most widely accepted is the Vancouver system, which recognizes three major types of postoperative and intraoperative fractures. Early recognition and careful examination for fracture propagation are critical to the management of intraoperative periprosthetic femur fractures. This article reviews the current status of diagnosis and management of periprosthetic fractures of the femur associated with total hip arthroplasty.

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