Periprosthetic Fractures in Hip Arthroplasty
Summary
Periprosthetic fractures are breaks in the femur occurring adjacent to a hip implant. As the number of primary and revision hip arthroplasties rises globally, these fractures have become an increasing source of morbidity, mortality and healthcare burden. Management is guided by the Vancouver classification, which stratifies fractures by anatomical site, implant stability and bone stock to determine whether internal fixation or implant revision is required. Key risk factors include advanced age, osteoporosis, implant design, cementation technique and intraoperative bone damage. Surgical repair aims to restore load‐bearing function and allow early mobilisation, yet remains challenging in elderly or comorbid patients. Recent progress in prosthesis engineering, intraoperative imaging and perioperative care pathways has improved fixation success rates, but optimal prevention strategies and standardised treatment algorithms are still under active investigation.
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Periprosthetic Fractures in Hip Arthroplasty publication trend
The graph below shows the total number of articles in periprosthetic fractures in hip arthroplasty across all publications each year (not limited to Nature Index journals).
Technical terms
Periprosthetic fracture: A break in bone adjacent to an orthopaedic implant.
Vancouver Classification: A system categorising femoral periprosthetic fractures by location, implant stability and bone quality to guide treatment choice.
Open reduction and internal fixation (ORIF): Surgical realignment of a fracture with subsequent stabilisation using plates, screws or rods.
Aseptic loosening: Loss of implant fixation without infection, often due to mechanical wear or bone resorption.
Implant stability: The mechanical support and fixation strength at the prosthesis–bone interface.
References
- The incidence of postoperative periprosthetic femoral fracture following total hip replacement: An analysis of UK National Joint Registry and Hospital Episodes statistics data. PLOS Medicine (2024).
- Biomechanics of PHILOS plates in Vancouver B1 periprosthetic femoral fracture. Frontiers in Bioengineering and Biotechnology (2023).
- Fracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review. Archives of Orthopaedic and Trauma Surgery (2020).
- Periprosthetic fractures: the next fragility fracture epidemic? A national observational study. BMJ Open (2020).
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