Periprosthetic Hip Fractures
What are Periprosthetic Hip Fractures?
Hip replacement is a surgical procedure in which the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. Any resulting fractures or breaks in the bone around the implant are called periprosthetic hip fractures. They usually occur around the stem of the implant and sometimes to the socket (acetabulum).
Risk Factors
Periprosthetic hip fractures may occur due to:
- A fall or trauma
- Rheumatoid arthritis
- Weak bones due to ageing
- Excessive use of corticosteroids
- Stress on the screw holes of the implant
- Neurological problems
- Poor vision or balance
- Revision surgery (replacement of faulty prosthetic parts implanted previously)
Symptoms
You may experience pain and swell around the hip or thigh. Other symptoms include an inability to bear weight and a deformed leg.
Diagnosis
Diagnosis involves a doctor’s examination followed by injury stabilisation to prevent further damage. Your hip is stabilized by applying a traction device to keep the leg straight. Your doctor orders an X-ray, MRI or CT-scan. Blood tests may also be ordered.
Treatment
Periprosthetic hip fractures are usually treated surgically, under general or regional anaesthesia. The surgical procedure may be either of the following:
Joint-Revision Surgery: Some cases of periprosthetic hip fracture are caused by a loose implant. Joint-revision involves the removal of the old implant and placement of a new implant with special components to treat the fracture.
Open Reduction and Internal Fixation (ORIF): Some cases of periprosthetic hip fracture do not require replacement of the implant. The fractured bone fragments are fixed with the help of screws.
Both types of surgery noted above may include the transplant of bone tissue to fractured or weakened areas - a procedure called bone grafting.
After Surgery
- You may have to stay for a few days before discharge from the hospital. Your doctor will prescribe antibiotics to prevent infections and blood-thinning medications to minimise the risk of clots around the surgical area.
- A combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids may be used to manage pain.
Rehabilitation
Your surgeon may suggest a recovery in a rehabilitation centre. Initially, your physical therapist will train you to use walking aids and bear partial weight. You will be allowed to perform specific physical therapy exercises as you heal.
