Ricci's 2015 state-of-the-art review covers the evaluation and surgical management of periprosthetic femur fractures around hip and knee arthroplasty implants — addressing classification systems, ORIF vs. revision arthroplasty decision-making, fixation technique nuances, weight-bearing protocols, and reported outcomes for both shaft and distal femur locations.
When you see a periprosthetic femur fracture, your first move is to classify it (Vancouver for hip, Lewis-Rorabeck/Su for knee) and determine stem stability — that single decision separates ORIF from revision arthroplasty.
Counsel families early: these patients carry mortality risk equivalent to hip fractures, not elective arthroplasty, and distal femur locations above TKA have meaningfully higher complication rates than shaft fractures.
Ricci's 2015 state-of-the-art review covers the evaluation and surgical management of periprosthetic femur fractures around hip and knee arthroplasty implants — addressing classification systems, ORIF vs. revision arthroplasty decision-making, fixation technique nuances, weight-bearing protocols, and reported outcomes for both shaft and distal femur locations.
When you see a periprosthetic femur fracture, your first move is to classify it (Vancouver for hip, Lewis-Rorabeck/Su for knee) and determine stem stability — that single decision separates ORIF from revision arthroplasty.
Counsel families early: these patients carry mortality risk equivalent to hip fractures, not elective arthroplasty, and distal femur locations above TKA have meaningfully higher complication rates than shaft fractures.