Abstract
Periprosthetic femoral fractures are among the most difficult and expensive complications of total hip arthroplasty. A rise in the elderly population and the increased indications of primary and revision hip arthroplasty has led to an escalating incidence. Intraoperative periprosthetic fractures are becoming more common given the increased numbers of revision total hip arthroplasty and the use of cementless fixation. Risk factors for intraoperative periprosthetic fractures include the use of minimally invasive techniques; the use of press-fit cementless stems and cups; revision surgery, specially when a long cementless stem or a short stem with impaction allografting is used; female gender; metabolic bone disease; bone diseases leading to altered morphology such as Paget disease and technical errors during the operation.
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