Outcomes of revisions and fixations following periprosthetic fractures around the hip: a retrospective service evaluation

Styliani Zachari; Amr H Ahmed; Alexander Mott; Osama Tawfiq; Syed S Ahmed

doi:10.1016/j.jcot.2025.103080

Outcomes of revisions and fixations following periprosthetic fractures around the hip: a retrospective service evaluation

J Clin Orthop Trauma. 2025 Jun 5:68:103080. doi: 10.1016/j.jcot.2025.103080. eCollection 2025 Sep.

Authors

Styliani Zachari¹, Amr H Ahmed¹, Alexander Mott¹, Osama Tawfiq¹, Syed S Ahmed¹

Affiliation

¹ Trauma and Orthopaedic Department, Maidstone and Tunbridge Wells Hospitals NHS Trust, UK.

PMID: 40538445
PMCID: PMC12175725 (available on 2026-06-05)
DOI: 10.1016/j.jcot.2025.103080

Abstract

Background: Our study aims to report clinical outcomes of revision and ORIF for managing periprosthetic proximal femur fractures (PPFFs).

Materials & methods: We conducted a two-year retrospective analysis at a level 2 trauma centre, focusing on surgically managed PPFFs from primary and revised total hip and hemiarthroplasties. Primary outcomes were the one-year reoperation rate and mortality rate following revision or ORIF. We also specifically analysed B2 fracture management. Secondary outcomes were complication rates, time to surgery, length of hospital stay, transfusions and critical care requirements.

Results: 67 patients were included, 44 (66 %) of whom were female. Mean age at operation was 83 years. Among them, 27 (40 %) had revision and 40 (60 %) had ORIF. One year reoperation rate was 11.11 % for revision and 7.50 % for ORIF. One year mortality rate was 25.93 % for revision and 10 % for ORIF. The overall complication rate was 29.63 % for revision and 7.50 % for ORIF. Time to surgery (89 and 77 h) and length of hospital stay (18 and 17 days) were similar in both groups.B2 fractures, which constituted 48 (71.64 %) of the cases, had a higher proportion of revision surgeries (27) compared to ORIF (21). For B2 fractures, revision was associated with higher reoperation and mortality rates as well as a significantly greater complication rate compared to ORIF.

Conclusion: PPFFs present a substantial healthcare challenge. Improving clinical outcomes for PPFF patients is crucial. This study highlights that ORIF may yield better outcomes for B2 fractures, when anatomical reduction is feasible. (249 words).