Characteristics and Risk Factors of Atypical Periprosthetic Femoral Fractures Following Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Ayomide Michael Ade-Conde, Ahmad Hamade, Omar Al-Mohrej, Vickas Khanna, James Yan

Abstract read

In one paragraph

Article in Arthroplasty today, 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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0citing papers in PubMed

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1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Ayomide Michael Ade-CondeSchool of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.

Ahmad HamadeDivision of Family Medicine, Saint Francis Hospital, Wilmington, DE, USA.

Omar Al-MohrejDivision of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.

Vickas KhannaDivision of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.

James YanDivision of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Atypical periprosthetic femoral fractures (APFFs) are a challenging, albeit uncommon, complication after total hip arthroplasty (THA). This systematic review will evaluate the characteristics and risk factors associated with APFFs following THA. Methods: A systematic search of EMBASE, MEDLINE, CENTRAL, and CINAHL was performed from inception to October 6, 2025, for studies reporting APFFs after THA. Patient, surgical, and radiographic data were extracted. Random-effects meta-analyses pooled proportions and odds ratios (ORs). Results: Eight studies comprising 1072 THA patients with periprosthetic fractures were included. APFFs accounted for 120/1072 fractures (11.2%), with a pooled proportion of 11% (95% confidence interval [CI], 7%-18%; I Conclusions: Long-term bisphosphonate use may increase APFF risk after THA. These fractures typically occur late and have characteristic clinical and radiographic features. APFFs represent a high-risk subtype of periprosthetic fracture that requires careful surveillance and thoughtful surgical management. As THA volumes rise, prospective studies and standardized diagnostic criteria are needed to clarify incidence and inform prevention. Level of Evidence: Level III, Systematic review.

Indexed as

Atypical femoral fractureAtypical periprosthetic femoral fracturePeriprosthetic femoral fractureSystematic reviewTotal hip arthroplasty

Identifiers

PMID42292315

DOI10.1016/j.artd.2026.102048

PMCPMC13264190

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.