Periprosthetic fractures of the proximal femur: Beyond the Vancouver classification

Karl Stoffel, Tamara Horn, Luigi Zagra, Michael Mueller, Carsten Perka, Henrik Eckardt

Research output: Contribution to journalArticlepeer-review


The majority of periprosthetic femoral fractures are treated surgically. Surgical treatment may be revision only, revision in combination with open reduction and internal fixation (ORIF), or ORIF only. The treatment decision is dependent on whether the stem is loose or not, but loose stems are not always identified, resulting in unsatisfactory treatments. This article presents an algorithmic approach to identifying loose stems around proximal femoral periprosthetic fractures, taking patient history, stem design, and plain radiographs into consideration. This approach may help identifying loose stems and increase the probability of effective treatments.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalEFORT Open Reviews
Issue number7
Publication statusPublished - 2020


  • Algorithm
  • Loose stem
  • Periprosthetic femoral fracture
  • Revision total hip arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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