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General Consideration and Workup of Periprosthetic Fractures

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Periprosthetic Fractures of the Hip and Knee

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Abstract

Periprosthetic fractures occur around or adjacent to prosthetic joints or orthopedic implants. Currently, 0.8–1.1% of total hip arthroplasty (THA) and 0.5–1.1% of total knee arthroplasty (TKA) patients will experience a periprosthetic fracture in the first 5 years from surgery, and these numbers are expected to increase [1–5]. The ever-expanding indications for THA are leading to more implants being placed in younger as well as in older adults. The number of TKAs is also projected to increase continuously [3, 6]. Increased life expectancy combined with the increased numbers of arthroplasties is contributing to an overall increase in the number of periprosthetic fractures both in the United States and worldwide though periprosthetic fracture rates appear to be a relatively constant proportion (4.2–7.4%) of an increasingly large population of patients undergoing these primary and revision arthroplasty procedures [1]. Periprosthetic fractures are associated with significant morbidity and mortality [7, 8]. Recent literature suggests a 6% 1-year mortality rate after periprosthetic femur fractures with age and type of surgery potentially influencing mortality risk [7–9]. The majority of the deaths, 80%, occur within the first 3 months of sustaining the fracture [10]. Many treatment options exist for periprosthetic fractures including nonoperative management, surgical management with plate fixation or intramedullary fixation, nail/plate combination (NPC) constructs, and revision arthroplasty [11].

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Authors and Affiliations

  1. Orthopedic Trauma and Reconstruction Service, North Mississippi Medical Center, Orthopedic Trauma Clinic, Tupelo, MS, USA

    Matthew A. Frank

  2. University of South Florida, Tampa, FL, USA

    Hassan R. Mir

  3. Florida Orthopedic Institute, Tampa, FL, USA

    Hassan R. Mir

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  1. Division of Orthopedic Trauma and Adult Reconstruction, Jersey City Medical Center – RWJBarnabas Health, Jersey City, NJ, USA

    Frank A. Liporace

  2. Division of Orthopedic Trauma and Adult Reconstruction, Jersey City Medical Center – RWJBarnabas Health, Jersey City, NJ, USA

    Richard S. Yoon

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Frank, M.A., Mir, H.R. (2019). General Consideration and Workup of Periprosthetic Fractures. In: Liporace, F., Yoon, R. (eds) Periprosthetic Fractures of the Hip and Knee. Springer, Cham. https://doi.org/10.1007/978-3-319-43008-9_1

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