Risk Factors for Periprosthetic Fracture

Description

Dr Jonathan Vigdorchik gives his insights whilst discussing the risk factors for periprosthetic fractures during or immediately after total hip replacement surgery. He highlights that age (especially over 65 or 70), gender (female), using cementless femoral fixation, and minimally invasive approaches during a surgeon's learning curve elevate the risk of fractures. Dr Vigdorchik emphasizes the need for careful considerations in high-risk patients, suggesting options like cementing the stem, utilizing a collar or triple taper stem, or altering surgical approaches. Additionally, he outlines the protocol for addressing intraoperative fractures, using cable fixation above and below the fracture, and addressing stability with appropriate implant choices. Postoperatively, it allows for weight-bearing as tolerated for patients, with a caution about the increased risk of subsidence and the need for possibly extended use of walking aids.

DOI: 10.1302/3114-251143

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