Atypical periprosthetic femur fracture on an underestimated atypical femoral pattern. A case report

Case: Atypical fracture patterns, especially to the femur midshaft, have begun emerging since long-term bisphosphonate use was introduced. The same fracture pattern could arise around prosthetic hip implant, but the literature reports few cases regarding atypical periprosthetic femur fracture on previous total hip arthroplasty implant in patients on long-term bisphosphonate therapy. To our knowledge we report here the first case of atypical periprosthetic femur fracture arising after total hip arthroplasty implant on a previously identified but underestimated atypical femur pattern. Conclusion: Surgeons should never underestimate an atypical femur pattern on x-rays and always relate groin and thigh pain to hip pathology before performing total hip arthroplasty.