This 2008 JBJS current concepts review by Davidson et al. synthesizes the epidemiology, risk factors, classification, and management of intraoperative periprosthetic fractures during THA — covering both femoral and acetabular injuries — to guide the reconstructive hip surgeon facing these increasingly common complications.
When planning revision THA with cementless components — especially with impaction grafting or long diaphyseal stems.
Anticipate a meaningful fracture risk and have cerclage cables, cortical strut allografts, and longer bypass stems on the table; intraoperatively, a sudden change in resistance during stem insertion should be treated as a fracture until proven otherwise, with immediate radiographic confirmation.
Stable fixation achieved at the index procedure, guided by Vancouver fracture type, preserves equivalent long-term functional outcomes.
This 2008 JBJS current concepts review by Davidson et al. synthesizes the epidemiology, risk factors, classification, and management of intraoperative periprosthetic fractures during THA — covering both femoral and acetabular injuries — to guide the reconstructive hip surgeon facing these increasingly common complications.
When planning revision THA with cementless components — especially with impaction grafting or long diaphyseal stems.
Anticipate a meaningful fracture risk and have cerclage cables, cortical strut allografts, and longer bypass stems on the table; intraoperatively, a sudden change in resistance during stem insertion should be treated as a fracture until proven otherwise, with immediate radiographic confirmation.
Stable fixation achieved at the index procedure, guided by Vancouver fracture type, preserves equivalent long-term functional outcomes.