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The incidence of periprosthetic fractures is rising and effective management involves a multidisciplinaryapproach, and begins with taking a careful history to identify co-morbidities, prefracturemobility, and pre-fracture symptoms of loosening or acetabular erosion. Use ofNSAIDs and smoking status should be noted. Examination findings should focus on mentalstatus, any signs of infection, neurovascular status and the integrity of the soft tissue envelope.Clear radiographs are required to effectively comment on bone quality and the identification ofany pathological lesions. White cell count, CRP and ESR should help confirm the absence ofinfection and if any doubt exists, a pre-operative aspiration should be considered. Ideallysurgery should be performed within 2 days of fracture by a revision arthroplasty surgeon,followed by monitoring on a high dependency unit.With regard to the formulation of an operative strategy, certainly there is no substitute forcareful assessment of remaining bone stock, diameter of the canal, fracture configuration andpatient-related factors. There is a paucity of data in the current literature relating to themanagement of acetabular fractures. Displaced femoral fractures are managed with cerclagefixation along with bone grafting of any osteolytic lesions and revision of the bearing surfaces.Regarding femoral periprosthetic fractures it would appear that one should err on the side oflong stem revision arthroplasty +/- impaction allografting should any doubt exist aroundloosening of the implant since this reduces the one-year mortality rate and the risk of failure.FiguresFigure 1 Figure 2 Figure 3 Figure 4Thursday, October 7, 2010, 16:30-17:20Session A8: Periprosthetic Fractures in THATHA in Sickle Cell Disease Patients*Mojieb Manzary - Dhahran Health Center - Dhahran, Saudi ArabiaFawzi Fahad Alijassir - King Khalid University Hospital - ., .*Email: mojieb@gmail.com18 Patients with SCD and 2ndry Osteoarthritis of their hips due to Avascular Necrosisunderwent uncemented THA.There were 12 male and 6 female patients.Patient had their pre op WOMAC/SF-36/ HOOS /and Oxford hip scores recordedpreoperatively a well as 3 month, 6months and one year post op.The outcome scores at one year were significantly better than the pre operative scoresHowever, when compared to a matched cohort of patients who underwent THA for reasonsfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]