Periprosthetic fractures associated with osseointegration are infrequent and family managed.

Reference: Bone Joint J. 2020 Feb;102-B(2):162-169. doi: 10.1302/0301-620X.102B2.BJJ-2019-0697.R2. Authors: Hoellwarth JS¹, Tetsworth K², Kendrew J³, Kang NV⁴, van Waes O⁵, Al-Maawi Q⁶, Roberts C¹, Al Muderis M¹.
Femur x-ray with osseointegration
In patients with lower extremity amputation, Osseointegration allows better mobility than conventional socket prostheses and few cases of periprosthetic fractures have been found. Of the 518 osseointegration interventions performed between 2010 and 2018, 22 presented periprosthetic fractures (4.2%) and implant removal was not necessary in any case. It was found that the majority of fractures occurred due to a fall and that the 86% occurred within 2 cm of the proximal tip of the implant. An increased risk was identified for the female sex and for each kg above 80.4kg. Age, years since amputation, and bone density did not appear to play a role.

In conclusion, the risks of periprosthetic fractures should not alter consideration for an osseointegration procedure.

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Periprosthetic osseointegration fractures are infrequent and management is familiar.