Periprosthetic Hip Fracture: Causes and Management
This fracture occurs around or near one of the hip prosthesis components and, although not very common, creates a very complicated situation for the patient. They usually occur associated with trauma from falls from standing height and Osteoporosis.
There are some factors that make patients more prone to suffering a fracture, such as a loosened implant, a component in an inadequate position, “stress shielding” (which is the loss of bone density caused by a decrease in the usual stress on the bone in one area due to increased stress in a rigid fixation area of the prosthesis), or the most common as already mentioned, Osteoporosis.
Patients with joint hip prostheses are usually elderly, a time of life when multiple organs of the body have aged. The quality of vision, hearing, balance, and muscle strength are diminished, which leads to a high risk of suffering falls, being the second most important factor as a cause.
When a fracture occurs, the patient feels sudden pain in the hip or thigh, cannot move, and the pain usually increases when trying to move the leg, and in many cases, the limb presents deformity.
Management:
The only management is Hip Prosthetic Revision Surgery. In this intervention, in selected cases, fixation of the fracture can be performed if there is no loss of fixation of the prosthetic components or poor bone quality. However, in most cases, the prosthetic component that has loosened is replaced. The key to preventing this from happening again is to correctly choose the new implant, manage the Osteoporosis present, and carry out a strong intervention that seeks to prevent falls through nutritional optimization and rehabilitation with muscle strengthening.
