Periprosthetic fractures are a growing problem facing todays Orthopaedic surgeon. The increase is due to many factors. The population is aging and staying active and therefore more arthroplastys are being done. The indications for arthroplasty has increased as the success of the these procedures has increased. Also, the number of revision arthroplasty procedures is increasing due the large number of primary replacements done over the past 50 years. The review by Lindahl of Swedish Registry in 20061 showed a cumulative incidence of a periprosthetic hip fracture to be 0.4% following a primary total hip and 2.1% following a revision total hip.
Periprosthetic fractures can be treated with either revision arthroplasty or reduction with internal fixation. This edition of Techniques in Orthopaedics will focus on internal fixation of these fractures. I believe as do most of the authors of this edition of TIO, that most of these fractures can be treated with open reduction and internal fixation. This is but one way of caring for these fractures and it is up to the treating physician to choose the best option for the patient. This journal edition should serve as a reference for surgeons in search of the internal fixation techniques. This includes the use of newer polyaxial locking plates specifically designed for treating periprosthetic fractures of the femur, including fractures around total hips, total knees, and of the greater trochanter.
This edition also includes an article on the controversial topic of fixation of fractures with loose total hip implants. Also included is a article on a very new technique of Far Cortical Locking and its use with periprosthetic fractures.
I hope you enjoy this edition and find it useful in care of your patients.
© 2013 by Lippincott Williams & Wilkins
1. Lindahl H, Garellick G, Regner H, et al..Three hundred and twenty-one periprosthetic femoral fractures.JBJS.2006;88A:1215–1221.