Fracture after Total Hip Replacement

A break or crack in the artificial implant during or after the hip replacement process is termed as a periprosthetic fracture. It may occur in any part of the artificial implant although it is most commonly seen in the stem of the metallic component that is fixed within the femur. Treatment for this condition is surgical and it can be quite complicated as the patients are generally old in age and the bone structure has already weakened.


  • A fall on the ground
  • Vehicular accidents that cause high intensity trauma to the joint
  • Direct blow to the leg or hip
  • People suffering from Osteoporosis are at a higher risk
  • Inherent muscular weakness may decrease the stability of the joint and predispose a person to such injuries
  • Osteolysis- The bones may begin to thin out with age and this may lead to the loosening of the femoral stem


  • Severe pain around the hip and thigh
  • Swelling
  • Bruising
  • Discrepancy in the limb length as the injured leg tends to shorten
  • Limited range of motion
  • Inability to bear body weight


  • Detailed examination of the hip joint
  • Nerve testing to ensure the blood flow to the lower limbs is not affected
  • CT scan may be required to obtain a 3D image of the hip joint
  • Blood tests may be conducted to assess the general health condition of the patient
  • X-ray images of the pelvis, thigh and hip area may be required to analyze the severity of damage to the implant as well as surrounding bones


  • Weight bearing should be restricted to avoid stressing the joint
  • Traction may be used in some cases to straighten the leg and keep the bones in place
  • Open Reduction- A surgical procedure that may be recommended if the implant is still secure within the femur. The broken bones are surgically placed back in their position and fastened using screws or pins (internal fixation)
  • Bone graft may be required in some cases as it helps in healing the fracture.
  • Surgical replacement of the damaged implant. This process is called Joint Revision
  • Blood thinning medications may be prescribed post surgery to prevent clotting in the leg or hip
  • Anti-inflammatory medications to relieve pain
  • Physical therapy may be recommended to promote joint movement during recovery phase
  • A hip brace may be worn for a few weeks to prevent stress on the joint

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