Epidemiology of periprosthetic femur fracture around a total hip arthroplasty

Periprosthetic femoral fractures can be classified as intraoperative and postoperative fractures. The intraoperative fractures mostly occur during the insertion of the femoral stem. Depending on the fixation method used, differences in the incidence of intraoperative fractures have been reported. An increase of intraoperative fractures is reported with the introduction of uncemented stems and this is often a consequence of the effort to obtain a sufficient press-fit to gain initial stem stability. In revision surgery an even higher incidence has been reported, ranging between 3.6% and 20.9% when cemented or uncemented prostheses are used, respectively. This review article reports on the prevalence of periprosthetic femoral fractures around a total hip replacement.