The use of megaprosthesis for periprosthetic hip fracture: a case report.
A. Perna1, R. Vitiello1, M.S. Oliva1, G. Maccauro1, A. Ziranu1
1 Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia – Università Cattolica del Sacro Cuore, Roma
Nowadays, due to the demographic changes affecting the world population, prosthetic hip replacement surgeries are constantly increasing and represent one of the most common surgical procedures in patients over sixty-five years. Related to the growing number of prosthetic implants, revision interventions and complications have also increased. While many total hip replacement surgeries are easily achievable with a prosthetic replacement, complication management, such as periprosthetic fractures, is more complex. These fractures, in recent years are becoming a real pathology. They mainly concern elderly patients with poor bone quality. This is often accompanied by osteolysis phenomena that make difficult a correct reduction and synthesis of the fracture. Complex cases frequently occur that are difficult to manage with conventional prostheses. Treatment of periprosthetic fractures depends on the type of fracture, bone quality and patient co-morbidities. However, sometimes the reconstruction options are limited. Although the use of hip mega-prostheses is mainly reserved for the treatment of pathological fractures of the proximal femur, primary or metastatic tumor localizations, it currently represents an extreme possibility in the management of complex periprosthetic fractures.