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Fracture After Total Hip Replacement

A periprosthetic fracture is a broken bone that occurs around the components of a total hip replacement. Though rare, it is a serious complication of hip replacement surgery that should be treated as soon as possible.

Most periprosthetic fractures occur after a patient has been living with a hip replacement for several years. Treating these fractures can be a challenge, largely because patients tend to be older. They are also more likely to have weaker bones and other medical conditions.

Causes & risk factors

Periprosthetic fractures are most often caused by a fall or other trauma to the hip, such as in a car accident.

Other conditions tend to increase a patient's likelihood of a fracture, including:

  • Bone-weakening conditions, such as osteoporosis
  • Muscle weakness
  • Poor vision
  • Balance disorders

A loosened femoral stem is also a major risk factor. This loosening typically occurs over a long period of time, often just from everyday activities. It can also result from a biologic thinning of the bone called osteolysis.


The most common symptoms of periprosthetic hip fracture include:

  • Pain around the hip or thigh
  • Swelling and bruising around the hip or thigh
  • Inability to bear weight on the injured leg
  • Injured leg appears shorter or deformed


Periprosthetic hip fractures are extremely painful and usually have patients heading straight for the emergency room.

In the emergency room, both a physician and an orthopaedic surgeon will work to diagnose and treat you. During your diagnosis:

  • The affected hip is closely examined and blood flow in the lower portion of the leg is assessed to ensure that the main nerve that travels around the hip joint (the sciatic nerve) is functioning well.
  • X-rays of your pelvis, hip and femur bones will be taken. Your doctor will examine the quality of the bone, the number of broken pieces and the extent of the break.
  • You will likely be admitted to the hospital. During your stay, blood and other tests will be run to give information about your overall health and ready you for surgery to repair the break.
  • You will not be permitted to put any weight on your injured leg. You may also receive a traction device to keep your leg straight. 


Most cases of periprosthetic hip fractures require surgery. Your doctor will discuss your treatment options with you in greater detail after assessing the extent of the injury, the quality of the remaining bone and your overall health.

To learn more, call 714-456-7012 or schedule an appointment online ›

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