Prevention of Periprosthetic Fractures: What Should We Be Doing to Address This Impending Epidemic?

➢ Periprosthetic fractures after total hip arthroplasties represent a growing surgical emergency with high associated morbidity and mortality.➢ Projections from national joint registries indicate that the absolute number of these fractures will rise substantially over the coming decades as the volume of primary arthroplasties increases and the population with implants ages.➢ The consequences for patients and health systems are severe: mortality following periprosthetic fractures rivals that following hip fragility fractures, reoperation rates are high, and implant survival after fixation is substantially compromised. Therefore, prevention must be considered an integral part of arthroplasty care.➢ We examine the mechanisms and classification of periprosthetic fractures with a focus on periprosthetic proximal femoral fractures after a total hip arthroplasty.➢ Arthroplasty surgeons must adopt a holistic, multidisciplinary approach to reduce harm to patients.