Managing periprosthetic fractures in THA

Wanshou Guo MD. The number of total hip arthroplasties (THA) is increasing over time, in line with the increasing average age of the population. The AOANJRR in2016 reported on over 498 thousand hip replacements. The utilisation of total hip arthroplasty continues to increase in the community. From the inception of the AOANJRR in 2003 the number of THA undertaken per year has increased 82%. This increase in primary THA is associated with a corresponding increase in revision hip arthroplasty. The NJRR reported nearly 22% increase in revision THA procedures, with fractures, the third commonest reason (19%) for revision of THA. Peri-prosthetic fractures are more common around the femoral (5%) than the acetabular component (0.4%). Revision of the femoral component alone is the commonest type of revision accounting for nearly 32% of all THA revisions. Peri-prosthetic fractures around THA commonly compromise stability of the femoral component in the proximal femur; furthermore, peri-prosthetic femoral fractures can occur on a background of osteolysis, femoral component loosening, or bone loss; necessitating revision of the component to achieve stability.