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Periprosthetic Infection in the Setting of Periprosthetic Total Hip Fractures: Evaluation and Management

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.5435/JAAOS-D-21-00083

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The incidences of periprosthetic fracture and periprosthetic joint infection after total hip arthroplasty are expected to increase exponentially. It is suggested that there is a possibility of coexistence of periprosthetic fracture and infection, particularly in patients with a loose femoral implant and high pretest possibility. Limited literature is available for guidance on managing this complex issue.
The incidences of periprosthetic fracture and periprosthetic joint infection after total hip arthroplasty are expected to increase exponentially over the coming decades. Epidemiologic data suggest that many periprosthetic fractures after THA occur concurrently with a loose femoral implant. Recent studies suggest an approximately 8% incidence of indolent infection in cases of suspected aseptic loosening. The available data, therefore, suggest that periprosthetic fracture and infection may coexist, and this possibility should be considered, particularly in patients with a loose femoral stem and high pretest possibility. Although currently limited, the available literature provides some guidance as how to manage this complex issue.

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