{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:33:10Z","timestamp":1760059990594,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Implantation of modularly built-up stems with a tapered and fluted design is currently state of the art in revision total hip arthroplasty (RTHA). Nevertheless, implant-specific major complications like breakage of taper junctions as well as periprosthetic fractures (PPFs) may lead to failure of reconstruction during follow-up. Methods: A cohort of 117 cases receiving femoral RTHA by a modular stem was investigated retrospectively with a mean follow-up of 5.7 (0.5\u201313.7) years. Cumulative risk and potential factors affecting the occurrence of PPFs were calculated with the Kaplan\u2013Meier method. In addition, cases were presented to discuss operative treatment options. Results: A cumulative risk of PPF of 12.1% (95% CI: 0\u201324.6%) was calculated at 13.7 years. Female patients had significantly higher risk compared to male patients (0% after 13.5 years for male patients vs. 20.8% (95% CI: 0.5\u201341.2%) after 13.7 years for female patients; log-rank p = 0.0438) as all five patients sustaining a PPF during follow-up were women. Four fractures were treated by open reduction and internal fixation. Non-union and collapse of the fracture occurred in one patient after closed reduction and internal fixation. Conclusions: Postoperative PPF after femoral revision with a modular stem has shown to be a frequent complication within this mid-term follow-up. Female patients were at a significantly higher risk in this aged cohort, indicating osteoporosis as a risk factor. The surgical treatment of PPF with an integrated long-stemmed prosthesis is challenging and thorough considerations of adequate operative treatment of PPFs are strongly advised in order to limit complication rates.<\/jats:p>","DOI":"10.3390\/jcm14155321","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:05:47Z","timestamp":1753711547000},"page":"5321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cumulative Risk for Periprosthetic Fracture and Operative Treatment Options After Revision Total Hip Arthroplasty with a Modular and Tapered Revision Device\u2014A Consecutive Series of 117 Cases in a Mid-Term Duration"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9221-3908","authenticated-orcid":false,"given":"Oliver E.","family":"Bischel","sequence":"first","affiliation":[{"name":"BG Trauma Center, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67 071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8133-156X","authenticated-orcid":false,"given":"Matthias K.","family":"Jung","sequence":"additional","affiliation":[{"name":"BG Trauma Center, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67 071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Pilgrim","sequence":"additional","affiliation":[{"name":"BG Trauma Center, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67 071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-8726","authenticated-orcid":false,"given":"Arnold J.","family":"H\u00f6ppchen","sequence":"additional","affiliation":[{"name":"Medical Faculty Mannheim, University of Heidelberg, Ludolf-Krehl-Str. 13-17, 68 167 Mannheim, Germany"},{"name":"Neckar-Odenwald-Hospital Mosbach, Academic Teaching Hospital of Heidelberg University, Knopfweg 1, 74 821 Mosbach, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-4822","authenticated-orcid":false,"given":"Paul M.","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"General Orthopedics, Pl\u00e4ntschweg 25, 81 247 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rn B.","family":"Seeger","sequence":"additional","affiliation":[{"name":"Parc Clinic, Am Kaiserberg 2-4, 61 231 Bad Nauheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e466","DOI":"10.5435\/JAAOS-D-23-00645","article-title":"Evaluation and Management of Acetabular Bone Loss in Revision Total Hip Arthroplasty: A 10-year Update","volume":"32","author":"Sanghavi","year":"2024","journal-title":"J. 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