If you or a loved one has recently undergone a total hip replacement, you may be concerned about possible complications such as a fracture after hip replacement.. This issue, known as "periprosthetic fracture", although rare, is serious and requires immediate attention.. Clinic in Tehran.... Now let's get into the details!...Description of fracture after hip replacement A post-hip replacement fracture is a bone fracture that occurs around or near an orthopedic implant.... This article focuses on periprosthetic fractures after total hip replacement.... For more information on **post-total knee replacement fractures**, see related articles.... Although fractures can occur during hip replacement surgery, most fractures occur after hip replacement: In the first few weeks after surgery years after a successful total hip replacement fortunately these fractures are rare....this is a serious complication that often requires surgery and treatment is often challenging because patients may be older and have thinner bones or other medical conditions...femur socket (acetabulum) is less common..the bone around the implant, as well as the amount of force involved in the injury...cause of fracture after hip replacement Fractures after hip replacement are often caused by a fall or impact. They can also be caused by a higher-energy force, such as a direct blow to the thigh or a motor vehicle collision. Several things can put people at increased risk for a fracture after hip replacement, such as: Having more risk factors for falls, such as muscle weakness, poor vision, or poor balance....Having a condition that weakens the bones, such as **osteoporosis**....a loosening of the femoral stem....this is a major risk factor....this loosening usually occurs over a long period of time and is often due to everyday activities....it can also be the result of bone thinning called osteolysis or prosthetic infection **total hip replacement**.... Fracture symptoms after hip replacement The most common fracture symptoms after hip replacement are: Pain around the thigh or leg Swelling and bruising around the thigh or leg Inability to bear weight on the affected leg The affected leg looks shorter or misshapen. Because these types of injuries are often very painful, someone who has a fracture after a hip replacement will likely go straight to the emergency room.. Imaging tests... X-rays of the bones of the hip, pelvis, and thigh show the doctor how complex the fracture pattern is.... These images can show the quality of the bone, the number of broken pieces, and the amount of displacement (distance between the broken pieces).... In some cases, your doctor will also order a CT scan. (CT)...CT scans will likely provide three images of the bone structure..Hospitalization....Blood tests and other lab tests can give your doctor important information about your general health and help you prepare for surgery...You will not be allowed to put weight on the injured leg....Your doctor may put a small traction device on your leg to help keep your leg straight and prevent further injury....Treatment of a fracture After hip replacement Most fractures after hip replacement require surgery... To determine the right treatment for you, your doctor will consider several factors, including: - Fracture type and location - The quality of the remaining bone - Is the implant in the hip loose or not? - Your general medical health Patients requiring surgery may stay in the hospital for several days before surgery. This is often because patients with post-hip replacement fractures require medical stabilization. Open surgery and internal fixation Revision total hip replacement with replacement of some or all implants or a combination of both. ### Open surgery and internal fixation If your implant is still firmly attached to your femur, your doctor may recommend internal fixation to treat the fracture.. During this procedure, the bone fragments are first placed in their natural position (reduced), then held together with special screws or cables or by attaching metal plates to the outer surface of the bone. Allograft (bone from a deceased donor that has been sterilized and stored) is often used in the treatment of periprosthetic hip fractures... In some cases of hip replacement fractures, the implant stem is loose.... In these cases, the original implant must be removed from the bone and replaced with a new implant.... This procedure is called revision.... Revision surgery may require special components.. After hospitalization in The hospital will perform surgery as soon as it is medically safe.... ### Anesthesia Once you are admitted, you will be assessed by a member of the anesthesia team.. Surgery to treat a hip fracture is often done using general anesthesia (you will be put to sleep).... You, the anesthesiologist, and your surgeon will discuss the type of anesthesia to be used... Surgery to repair a fracture surrounding a total hip replacement can be challenging....factors such as poor bone quality, comminution of the fracture (multiple bone fragments) and in some cases the presence of bone cement add to the complexity of the case....it is not uncommon for these surgeries to take more than 3 hours....anesthesia is monitored....after you wake up you will be taken to your hospital room.... ### recovery You will likely stay in the hospital for a few days after surgery. After surgery, you will likely have intravenous (IV) antibiotics for a while to help prevent infection. In addition, your surgeon will prescribe blood-thinning medications to help reduce the risk of blood clots in your leg (deep vein thrombosis). Use opioids.... Be aware that although opioids help relieve pain after surgery, they are narcotic drugs and can be addictive.... Opioid dependence and overdose have become public health issues in the United States... If you haven't started after surgery.. In most cases, physical therapy will begin immediately after surgery.. Your surgeon will determine how much weight you can put on your recovering leg..... A physical therapist will teach you how to put light weight on your leg and use a safe walker.. You may also need a brace for a few weeks after surgery to further protect your hip until the fracture heals.. After the initial hospitalization, you may spend several weeks in a skilled nursing facility or rehabilitation center to improve your strength and general health.. ### Possible Complications of Surgery Complications after hip replacement surgery can be serious. The most common complications are: Infection, blood clots, dislocation, limb length inequality, poor healing, fracture, re-fracture, lack of internal growth of a new stem inserted into the femur, nerve or blood vessel damage. ### Additional surgery In some cases, it is necessary to repeat the operation to remove the complication... It is important to discuss the risks and benefits of this method with your orthopedic surgeon before surgery.... **Conclusion** Fracture after total hip replacement can be scary, but with early diagnosis and proper treatment by an experienced specialist like Dr. Homan Kokbi, you can get a doctor's recommendation for a strong recovery. We are ready to help you!... If this post was useful, share it with your friends and write your comments....