[Risk Factors and Prevention Strategies for Periprosthetic Femoral Fractures in Hip Arthroplasty]

Overview

Journal Orthopadie (Heidelb)

Specialty Orthopedics

Date 2024 Sep 24

PMID 39317786

Authors

Assil-Ramin Alimy

Pauline Julie Soltys

Jan Hubert

Christian Ries

Frank Timo Beil

Tim Rolvien

Affiliations

Soon will be listed here.

Abstract

Background: Periprosthetic fractures represent a major complication following joint replacement surgery, particularly total hip arthroplasty (THA). Due to demographic changes, a rising number of THAs is expected to lead to an increase in periprosthetic femoral fractures (PPF) in the coming decades. Despite the resulting high clinical relevance, there is as yet no comprehensive overview of risk factors and possible preventive approaches to PPF.

Objectives: The aim of this review is to present current findings and data from various studies and to derive evidence-based recommendations for clinical practice.

Methods: Narrative review.

Results: Various factors, such as advanced age, female sex, and rheumatic conditions, can increase the risk of PPF. In the presence of risk factors, a comprehensive assessment of bone health, including DXA osteodensitometry, should be considered prior to surgery.

Conclusions: An individualized approach is essential in the planning and execution of THAs to minimize the risk of PPF. In cases of confirmed osteoporosis or for women aged ≥ 70 years and men aged ≥ 75 years, cemented stem fixation should be chosen, as uncemented stems are associated with an increased risk of PPF. Overall, the clinical risk profile should be considered in preoperative planning and postoperative care to reduce this complication and improve patient care.

Citing Articles

[Surgical treatment strategies for periprosthetic femoral fractures of type Vancouver B].

Ries C, Gerhardt P, Helwig P, Bathis H, Kirschner S, Rolvien T Orthopadie (Heidelb). 2025; 54(3):205-217.

PMID: 39966160 PMC: 11868169. DOI: 10.1007/s00132-025-04613-y.

Intraoperative Periprosthetic Fractures in Total Hip Arthroplasty: A 1.6-Million-Patient Analysis of Complications, Costs, and the Challenges in AI-Based Prediction.

Maman D, Steinfeld Y, Yonai Y, Fournier L, Bar O, Safir O J Clin Med. 2024; 13(22).

PMID: 39598005 PMC: 11594302. DOI: 10.3390/jcm13226862.

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