International Orthopaedics

, Volume 42, Issue 9, pp 2069–2076 | Cite as

Periprosthetic femoral fracture as cause of early revision after short stem hip arthroplasty—a multicentric analysis

  • Sang-Min Kim
  • Seung-Beom Han
  • Kee Hyung Rhyu
  • Jeong Joon Yoo
  • Kwang-Jun Oh
  • Je Hyun Yoo
  • Kyung-Jae Lee
  • Seung-Jae Lim
Original Paper



The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems.


A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited. Mean patient age was 57.4 years (range, 18–97 years), with a male ratio of 49.7% (541/1089). Re-operation for any reason within two years was used as an endpoint. The incidence and clinical characteristics of the periprosthetic femoral fractures were also recorded. Mean follow-up period was 5.1 years (range, 2–7.9 years).


Early re-operation for any reason was identified in 16 (1.5%) of 1089 hips. The main reason for re-operation was periprosthetic femoral fracture, which accounted for eight (50%) of the 16 re-operations. The overall incidence of periprosthetic femoral fracture at two years was 1.1% (12/1089). According to the Vancouver classification, two fractures were AG type and the other ten were B1 type. Advanced age, higher American Society of Anesthesiologist grade, femur morphology of Dorr type C, and the use of a calcar-loading stem increased the risk for periprosthetic femoral fracture.


Periprosthetic femoral fracture was the major reason for re-operation after hip replacement surgery using short bone-preserving stems accounting for 50% (8/16) of re-operations two years post-operatively, but did not seem to deteriorate survivorship of implanted prostheses.


Reoperation Periprosthetic femoral fracture Short stem Hip replacement 


Compliance with ethical standards

This study was approved by the institutional review board

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Sang-Min Kim
    • 1
  • Seung-Beom Han
    • 2
  • Kee Hyung Rhyu
    • 3
  • Jeong Joon Yoo
    • 4
  • Kwang-Jun Oh
    • 5
  • Je Hyun Yoo
    • 6
  • Kyung-Jae Lee
    • 7
  • Seung-Jae Lim
    • 8
  1. 1.Department of Orthopaedic SurgeryKorea University Guro Hospital, Korea University School of MedicineSeoulSouth Korea
  2. 2.Department of Orthopedic Surgery, College of Medicine, Anam HospitalKorea UniversitySeoulSouth Korea
  3. 3.Department of Orthopedic Surgery, College of MedicineKyung Hee University Hospital at Gangdong, Kyung-Hee UniversitySeoulSouth Korea
  4. 4.Department of Orthopedic SurgerySeoul National University College of MedicineSeoulSouth Korea
  5. 5.Department of Orthopedic SurgeryKonkuk University Hospital, Konkuk University School of MedicineSeoulSouth Korea
  6. 6.Department of Orthopedic SurgeryHallym University Sacred Heart hospitalAnyangSouth Korea
  7. 7.Department of Orthopedic Surgery, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  8. 8.Department of Orthopedic Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

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