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Treatment Protocol for Proximal Femoral Periprosthetic Fractures
Javad Parvizi, MD, FRCS; Venkat R. Rapuri, MD; James J. Purtill, MD; Peter F. Sharkey, MD; Richard H. Rothman, MD, PHD; William J. Hozack, MD
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Dec 01;86(suppl 2):8-16
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The outcome of an otherwise successful total hip arthroplasty is occasionally compromised by complications. Fracture around the femoral stem is a rare but potentially problematic complication of total hip arthroplasty. Such fractures can range from being minor, with minimal or no effect on the outcome, to being catastrophic and possibly creating an unreconstructable problem with an immense effect on the patient's function.The prevalence of periprosthetic fractures is on the rise. Periprosthetic fractures of the femur are more frequent during arthroplasties performed without cement and following revision total hip arthroplasties. Currently, the prevalence of femoral fractures has been estimated to range from 0.1% to 3.2% for primary total hip arthroplasties without cement and from 3% to 12% for revisions performed with cement1. The introduction of uncemented press-fit stems has resulted in a substantial increase in intraoperative fracture rates, ranging from 3% to 46%1. With the substantial increase in the number of total hip arthroplasties being performed and the growing number of patients with a total hip arthroplasty in place for more than thirty years, the prevalence of periprosthetic fractures is anticipated to rise even further.
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