This 2011 narrative review synthesizes incidence data, risk factors, and future projections for periprosthetic fractures across hip, knee, and shoulder arthroplasties as well as fracture fixation implants (particularly the gamma nail). It asks: how common are these fractures, who is at highest risk, and where is the trend headed?
When planning revision THA — especially with cementless stems in elderly or osteoporotic patients.
Anticipate substantially elevated periprosthetic fracture risk and counsel accordingly; early surgical intervention for radiographically loose implants before fracture occurs is preferable to fracture repair, which carries poor results.
When treating intertrochanteric fractures with an intramedullary nail, recognize that modern gamma nail designs have largely closed the historical fracture-risk gap versus the compression hip screw, but meticulous technique (adequate reaming, avoiding forceful insertion) remains essential.
This 2011 narrative review synthesizes incidence data, risk factors, and future projections for periprosthetic fractures across hip, knee, and shoulder arthroplasties as well as fracture fixation implants (particularly the gamma nail). It asks: how common are these fractures, who is at highest risk, and where is the trend headed?
When planning revision THA — especially with cementless stems in elderly or osteoporotic patients.
Anticipate substantially elevated periprosthetic fracture risk and counsel accordingly; early surgical intervention for radiographically loose implants before fracture occurs is preferable to fracture repair, which carries poor results.
When treating intertrochanteric fractures with an intramedullary nail, recognize that modern gamma nail designs have largely closed the historical fracture-risk gap versus the compression hip screw, but meticulous technique (adequate reaming, avoiding forceful insertion) remains essential.