Contemporary management of periprosthetic femur fracture following total hip arthroplasty

Periprosthetic fractures following total hip arthroplasty (THA) represent a growing clinical challenge due to the increasing prevalence of hip replacements, particularly in an aging population. This review aims to provide a comprehensive analysis of the epidemiology, classification systems, and management strategies for periprosthetic femur fractures, focusing on the unique challenges posed by varying fracture types and patient-specific factors. These fractures significantly impact patient outcomes, often leading to compromised joint function, prolonged recovery, and higher morbidity and mortality. The scope of this manuscript includes a detailed evaluation of the Vancouver classification system, its clinical utility, and emerging insights into patient-specific treatment algorithms. Treatment options range from internal fixation, primarily used for stable prostheses, to revision arthroplasty in cases where the implant is loose or bone quality is poor. Additionally, this paper discusses recent advances in surgical techniques and prosthetic design innovations aimed at improving patient outcomes, with a focus on elderly patients with osteoporosis or multiple comorbidities. Continued innovation in fixation methods and implant technology is essential to improving outcomes for patients with periprosthetic hip fractures.