The management of complex periprosthetic fractures

Total hip and knee arthroplasties have been 2 extremely successful surgeries with respect to providing pain relief and increasing mobility. The number of primary and revision total hip arthroplasties continues to increase, and with this, the incidence of periprosthetic fractures continues to rise. Periprosthetic fractures around total hip and knee arthroplasties can prove to be a particularly challenging problem depending on location, bone quality, current implants, and patient comorbidities. Due to this, we advocate that only experienced surgeons address and treat complex periprosthetic fractures. Several general considerations must be considered when addressing these fractures. Preoperative planning is essential and begins with correctly classifying the fracture pattern that is present. Correctly classifying the fracture allows for detailed treatment plans to be formulated. Asking the patient if he or she had pain before the fracture is crucial. This may signify that the implant was loose prior to the fracture and change the treatment algorithm. A stable prosthesis-cement-bone or prosthesis-bone interface is essential for the function and survival of the components. Templating is extremely valuable and allows for the treating surgeon to ensure that the correct hardware and prosthesis are present for the