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Intraoperative Periprosthetic Fractures During Total Hip ArthroplastyEvaluation and Management
Darin Davidson, MD, MHSc1; Jeffrey Pike, MD1; Donald Garbuz, MD, MHSc, FRCSC1; Clive P. Duncan, MB, MSc, FRCSC1; Bassam A. Masri, MD, FRCSC1
1 Division of Lower Limb Reconstruction and Oncology (D.G.), Department of Orthopaedics (D.D., J.P., C.P.D., and B.A.M.), University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC V5Z 4E3, Canada. E-mail address for B.A. Masri: bas.masri@vch.ca
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. Commercial entities (Zimmer and Stryker) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2008 Sep 01;90(9):2000-2012. doi: 10.2106/JBJS.H.00331
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Intraoperative periprosthetic fractures are becoming more common given the increased prevalence of revision total hip arthroplasty and increased use of cementless fixation.

Risk factors for intraoperative periprosthetic fractures include the use of minimally invasive techniques; the use of press-fit cementless stems; revision operations, especially when a long cementless stem is used or when a short stem with impaction allografting is used; female sex; metabolic bone disease; bone diseases leading to altered morphology such as Paget disease; and technical errors at the time of the operation.

Appropriate treatment of intraoperative periprosthetic fractures does not compromise the long-term results of total hip arthroplasty unless the bone damage precludes stable fixation of the implant.

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