SynthesisEFORT open reviews2026
Management of infected periprosthetic fracture of hip and knee: a systematic review of the literature.
Synthesis in EFORT open reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The coexistence of periprosthetic joint infection (PJI) and periprosthetic fracture (PPFx) is one of the most challenging complications after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Evidence regarding the management and outcomes of concomitant PJI and PPFx remains limited. This systematic review aimed to evaluate treatment strategies for infected PPFx in order to optimise infection eradication, fracture healing, implant survival, and limb function. Methods: A systematic review was conducted according to PRISMA and Cochrane guidelines and registered in the PROSPERO database (CRD420251051853). Studies of level II-V evidence reporting on the management of infected PPFx following THA or TKA were included. Extracted data comprised patient demographics, fracture classification, pathogens, treatment strategies, complications, infection control, and fracture healing outcomes. Results: Thirteen studies involving 210 patients were included, with a percentage of hip fractures of 81.9%. The most frequently isolated pathogens were Staphylococcus epidermidis, Staphylococcus aureus, and Cutibacterium acnes. Treatment strategies varied and included revision arthroplasty, plating, intramedullary fixation, distally locked stems, and staged reconstruction with antibiotic-loaded cement or spacers. Fracture union rates ranged from 58 to 100%, while reinfection or recurrence occurred in 6-28% of cases. Stable fixation was associated with improved outcomes, particularly in Vancouver B1 fractures, whereas B2 and B3 fractures showed higher mechanical complication rates. Mortality was reported up to 22% predominately in frail populations. Conclusion: Infected periprosthetic fractures remain rare but involve severe complications. Staged protocols combining infection eradication with stable fixation provide the most consistent outcomes, although treatment should be individualised.
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