Page 38 - 2020 Annual Outcomes Report
P. 38

Periprosthetic Hip and Knee Fracture
by Travis Scudday, MD
Roughly one million hip and knee replacements are performed yearly in the United States. Additionally, patients are living longer with their hip and knee replacements.
As the prevalence of hip and knee replacements increases, so do the complications. One of the most devastating complications is a fracture around a previous implant. This happens in roughly 1% of replacements, and the incidence increases slightly as patients age.
Treatment of periprosthetic fractures varies depending on the stability of the original implants. If the implants remain stable and in good alignment, fixing the fractured bone is a viable option. This often requires extended periods of decreased weight-bearing as the bone heals. If the implants are knocked loose by the fracture, they must be replaced, often with longer and larger implants.
Revision surgeries for periprosthetic fractures are large and complex operations. Hoag Orthopedic Institute (HOI) is the largest joint replacement center in California. As a trusted referral center for the region, HOI brings experience and expertise to these difficult to treat problems. With a multidisciplinary approach that includes anesthesia, nursing and internal medicine, we can treat these complex patients successfully.
Often the rehabilitation phase is longer following a revision surgery for periprosthetic fracture than for the original surgery. A successful outcome is much more likely if the patient adheres to the rehabilitation guidelines. The specially trained physical and occupational therapists at HOI will demonstrate the necessary precautions for a successful outcome.
Postoperative hip replacement fracture with a loose femoral implant necessitated revision to a longer implant and fixation of the fracture with cables.
A fracture around a previous knee replacement forced a revision to a larger distal femoral replacement.

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