Periprosthetic fractures are the fractures that occur around the joint implant. Periprosthetic fractures are more common in patients over 65 years of age. The risk factors for post-operative periprosthetic fractures include age, female gender, osteoporosis, rheumatoid arthritis, neurologic disorders, previous hip or knee surgery, a previous history of femoral neck fracture, and implants placed for a long duration.
Management of periprosthetic fractures is based on fracture pattern, bone quality, location and severity of the fracture. A careful preoperative planning is essential for a successful surgical outcome. The reconstruction of periprosthetic fractures may either include replacement of the implant with a new implant or the fixation of the implant to the surrounding bone. The goal of treatment is to restore pre-fracture functional status of the patient. Fracture fixation can be done using wires, screws, cables, or metal plates. For patients with fragile brittle bones, a special locking plate device and locking screws have been developed to stabilize the fracture. Majority of these fractures are a result of osteolysis, hence a bone graft should be used to repair the osteolytic area. Periprosthetic fractures with extensive bone loss are reconstructed using modular prostheses.