Periprosthetic Fractures: A Rising Tide of Hip Arthroplasty Failure Noted in the American Joint Replacement Registry and the Preventative Role of Cemented Stems.

Background: This investigation examined cemented femoral component use in total hip arthroplasty (THA) and its impact on the incidence of periprosthetic fractures (PPFx), a common failure mode in THA. The study leverages data from the American Joint Replacement Registry (AJRR) to assess trends in cemented femoral component usage over time, its association with PPFx rates, and compares the survivorship and 90-day complication rates between cemented and cementless femoral component THAs.

Methods: Primary THAs, captured in the AJRR, in patients aged 65 years and older from 2012 to 2021 were analyzed.

Fixation Strategies for Periprosthetic Fractures With Stable Implants.

The fixation of periprosthetic fractures remains challenging and controversial. It is important to achieve consensus opinions regarding the management of stable periprosthetic fractures with internal fixation. Key strategies to optimize surgical decision making and fixation and manage complications following these difficult injuries are addressed.

Distal Femoral Replacement for Fractures Allows for Early Mobilization with Low Complication Rates: A Multicenter Review.

Periprosthetic fractures around a total knee arthroplasty (TKA), comminuted and intra-articular femur fractures, or fracture nonunions in osteoporotic bone represent technically challenging problems. This is particularly true when the fracture involves a loose femoral component or the pattern results in suboptimal fixation potential. These clinical indications often arise in an older and comorbid patient population in whom a principal goal of treatment includes allowing for early mobilization.

Complex Primary Total Knee Arthroplasty in a Patient with Achondroplasia, Osteoarthritis, and Severe Coronal Instability.

Genu varum in patients with achondroplasia is common and is often exacerbated by the associated generalized ligamentous laxity. Despite this, development of knee osteoarthritis is rare. There are only a few previously published case reports of total knee arthroplasty in this population.

Two pegs are better than one: rare mode of femoral component failure in unicompartmental arthroplasty requiring revision to total knee arthroplasty.

Femoral component fracture is a rare complication in unicompartmental knee arthroplasty, especially in cemented prostheses. We present a 75-year-old man who presented with a fractured single-peg Vanguard component 9 years postoperatively. He was revised to a total knee arthroplasty with an excellent functional outcome at 1 year.