Peri-Prosthetic Fracture Fixation

Overview

Peri-prosthetic fracture fixation is a specialized orthopedic procedure performed to treat fractures that occur around an existing joint replacement implant (hip or knee). These fractures are complex because they involve both the bone and the artificial implant.

They commonly occur due to:

• Falls in elderly patients

• Trauma after joint replacement

• Osteoporosis

• Implant loosening

• Minor injury in weakened bone

These cases require advanced planning to preserve the implant (if stable) or revise it (if loose).

What Is a Peri-Prosthetic Fracture?

A peri-prosthetic fracture is a break in the bone surrounding a previously implanted prosthesis such as:

• Total Hip Replacement (THR)

• Total Knee Replacement (TKR)

• Partial joint replacement

Treatment depends on:

• Implant stability

• Fracture pattern

• Bone quality

• Patient age and mobility level

Types of Surgical Management

1️⃣ Fracture Fixation (Implant Stable)

• Locking plates

• Cerclage wires

• Specialized long plates

• Intramedullary fixation

2️⃣ Revision Arthroplasty (Implant Loose)

• Long revision stems

• Modular implants

• Bone grafting

• Augments for bone loss

Each case is individualized for optimal stability.

When Is Surgery Required?

Surgery is usually required if:

• Fracture around hip/knee replacement

• Inability to bear weight

• Implant instability

• Severe displacement

• Pain and deformity

Early intervention prevents complications such as non-union and implant failure.

Challenges in Peri-Prosthetic Fractures

• Poor bone quality

• Osteoporosis

• Complex fracture patterns

• Existing implant interference

• Higher surgical difficulty

These cases demand revision-level expertise.

Benefits of Expert Fixation

✅ Restores limb alignment
✅ Maintains or replaces implant stability
✅ Enables early mobilization
✅ Prevents further bone loss
✅ Reduces risk of repeat fracture
✅ Preserves joint function

Recovery & Rehabilitation

• Early assisted mobilization

• Gradual weight bearing

• Bone healing monitoring

• Physiotherapy tailored to fracture type

Recovery varies depending on fracture severity and fixation method.