As patients who have had a hip replacement age, there is a decrease in the strength of their bones (osteoporosis) and an increase in the risk of fracture or break around the hip replacement.
By their nature, these are sudden injuries, although patients may have had discomfort prior to the injury. The replacement may have been in place for many years and have slowly started to loosen from the surrounding bone. How the injury is managed depends on whether the implant is loose or not. If the implant is well fixed then the pieces can be put back into their normal position and held in place with specialised plates. A small percentage will have an underlying infection, which would have contributed to their fracture in the first place.
If the implants are loose, then that means a more significant operation. The old hip replacement must be removed along with all the cement. The fracture is then reduced, fixed and a long stem implant introduced, so that it bypasses the break. this means that the whole construct is more stable, allowing the patient to put some weight through it. Rehabilitation is similar to that of revision for loosening and most patients remain partially weight-bearing for up to 3 months until the fracture is healed. This can be very difficult for an older patient whose mobility may be poor before the injury.