CME expires October 1, 2029
Go beyond traditional learning with a 360° perspective on orthopedic topics.
Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.
This Instructional Course Lecture provides a detailed and evidence-based review of periprosthetic femur fractures around the hip following total hip arthroplasty, addressing the factors driving their increasing incidence and the latest principles of classification, fixation, and reconstruction.
Editors
Utku Kandemir, MD, FAAOS
Benjamin K. Wilke, MD, FAAOS
Learning Objectives
- Describe the epidemiology, projected burden, morbidity, mortality, and risk factors associated with periprosthetic femur fractures after total hip arthroplasty.
- Apply the Vancouver classification system to postoperative periprosthetic femur fractures by integrating fracture location, femoral component stability, and remaining host bone stock.
- Differentiate Vancouver type B1, type B2, and type B3 fracture patterns based on pre-fracture symptoms, comparison radiographs, implant design, fracture timing, and intraoperative stem assessment.
- Select appropriate treatment strategies for Vancouver type AG, type AL, type B1, type B2, type B3, type C, early postoperative, intraoperative calcar, and interprosthetic femur fractures.
- Evaluate patient, anatomic, and surgical risk factors that may support cemented fixation, collared stem designs, prophylactic cerclage, or alternate fixation strategies during primary total hip arthroplasty.
- Apply contemporary fixation principles for Vancouver type B1, type C, greater trochanteric, and interprosthetic femur fractures, including plate length, proximal fixation, screw/cable strategy, stress riser bypass, and biologic preservation.
- Discuss the role of modular fluted tapered stems in revision total hip arthroplasty for Vancouver type B2 and type B3 fractures, including distal fixation, modularity, fracture fragment management, and complications.
- Recognize intraoperative calcar cracks and early postoperative fractures promptly and implement treatment algorithms that reduce progression to displaced periprosthetic fracture.
Earn up to 5 AMA PRA Category 1 CME credits™.