Orthonotes
Orthonotes
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Periprosthetic Fractures — Classification & Management

Classification guides treatment by considering fracture location, implant stability, and bone stock. THA femur: **Vancouver** (A: trochanteric; B1: around stem-stable; B2: around stem-unstable; B3: poor bone stock; C: distal). TKA periprosthetic femur: **Lewis–Rorabeck** (I: nondisplaced, stable; II: displaced, stable; III: loose component). Principles: fix stable implants; revise loose stems; restore alignment and biology with locking plates/cables/strut grafts or long-stem revision. Risk reduction: avoid notching in TKA, correct malalignment/osteolysis, treat osteoporosis.

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Classification guides treatment by considering fracture location, implant stability, and bone stock. THA femur: **Vancouver** (A: trochanteric; B1: around stem-stable; B2: around stem-unstable; B3: poor bone stock; C: distal). TKA periprosthetic femur: **Lewis–Rorabeck** (I: nondisplaced, stable; II: displaced, stable; III: loose component). Principles: fix stable implants; revise loose stems; restore alignment and biology with locking plates/cables/strut grafts or long-stem revision. Risk reduction: avoid notching in TKA, correct malalignment/osteolysis, treat osteoporosis.

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