Periprosthetic fractures happen when the bone around an artificial hip implant breaks, often due to a fall or weakened bone structure. While hip replacement is among the most successful and reliable surgeries, periprosthetic fractures occur in 2.4% of cases.
While this is concerning if it happens, our board-certified orthopaedic surgeon, Kevin Park, MD, specializes in repairing these fractures and helping patients get back on their feet.
Periprosthetic fractures can happen for several reasons, including:
If you experience sudden pain, swelling, or difficulty moving your leg after a hip replacement, we perform imaging tests. These tests may include:
This is the first imaging test we use to detect fractures and assess the position of the implant.
If the fracture is complex or difficult to see clearly on an X-ray, CT scans provide a more detailed image of the bone and implant.
Although not always necessary, MRI scans may be useful to check for soft tissue damage or hidden fractures.
The most common fracture pattern is the Vancouver B, which occurs in the femur (thigh bone) at the level of the prosthesis. This pattern accounts for around 65% of periprosthetic fractures.
Once we confirm the presence of a fracture, we classify it based on its location, its severity, and the stability of the hip implant. This classification helps us determine the best treatment approach.
Periprosthetic fracture treatment depends on several factors, including your overall health, fracture type, and whether the hip implant is stable.
We may recommend nonsurgical treatment if the fracture is small and the hip implant remains stable. This includes:
You may need crutches, a walker, or a brace to keep weight off the hip while the bone heals.
Gentle exercises help you maintain muscle strength and prevent stiffness while allowing the bone to heal naturally.
Bone-strengthening medications, such as calcium and vitamin D, help to support healing.
Repairing periprosthetic fractures — surgical
Most periprosthetic fractures require surgery for proper healing and to restore mobility. The type of surgery depends on the fracture’s severity and whether the hip implant remains stable, but options include:
If the hip implant is still firmly attached to the bone, Dr. Park can repair the fracture by securing it with metal plates and screws. This method stabilizes the bone while it heals.
Dr. Park may need to remove the old implant and replace it with a new one if the fracture has caused the implant to loosen or if the bone around it is severely damaged.
In cases where the bone is too weak to support the implant, Dr. Park may use bone grafts to strengthen the area. Bone grafts can come from your body or a donor.
If the fracture extends down the thigh bone (femur), Dr. Park may use an implant with a longer stem to provide extra stability and support for the healing process.
Recovering from a periprosthetic fracture repair can take several months. Here’s what you can expect:
Most periprosthetic fracture patients stay in the hospital for several days after surgery for monitoring and effective pain management.
Rehabilitation starts soon after surgery to help you regain strength and movement in the hip.
You will likely need to avoid putting any weight on the treated leg for several weeks.
Regular checkups with Dr. Park ensure the bone is healing correctly and the implant remains stable.
If you or a loved one experiences sudden hip pain or difficulty moving after a hip replacement, seeking prompt medical attention can make a significant difference in the outcome. Call us to schedule a consultation, or contact us using our online form.
