[Periprosthetic fractures: basics, classification and treatment principles]

Area of Science:

• Orthopedics
• Trauma Surgery
• Biomechanics

Background:

• Periprosthetic fractures (PPFx) are increasing due to more joint replacement surgeries.
• Existing classification systems for PPFx are numerous and varied.
• A unified classification system (UCS) has been introduced for all PPFx.

Purpose of the Study:

• To introduce the unified classification system (UCS) for periprosthetic fractures.
• To emphasize the need for individualized treatment strategies for PPFx.
• To highlight the importance of biomechanical principles in managing PPFx.

Main Methods:

• Application of the newly published unified classification system (UCS).
• Assessment of patient-dependent and independent factors for treatment planning.
• Evaluation of implant stability to guide surgical approach (osteosynthesis vs. revision arthroplasty).

Main Results:

• The UCS can be applied universally to all periprosthetic fractures.
• Conservative treatment is indicated only in exceptional cases.
• Implant stability is the key factor in choosing between osteosynthesis and revision arthroplasty.

Conclusions:

• The unified classification system simplifies PPFx management.
• Individualized treatment, considering biomechanical principles, is crucial for successful fracture consolidation and functional recovery.
• Operative treatment is generally preferred over conservative management for PPFx.