Surgical Treatment of Periprosthetic Acetabular Fractures After Hip Arthroplasty: A Report of Two Cases.

Bipolar hemiarthroplasty (BHA) and total hip arthroplasty (THA) are standard treatments for hip disorders in the elderly. However, a rare postoperative complication known as periprosthetic acetabular fracture (PPAF) can occur, potentially affecting hip joint stability and implant longevity. The management of PPAF is guided by the Della Valle and Paprosky classifications, which assess implant stability and the extent of bone loss. In this study, we report two cases of PPAF occurring after BHA and THA. In Case 1, early open reduction and internal fixation were performed, successfully avoiding stem revision and achieving a favorable clinical outcome. In contrast, Case 2 was initially managed conservatively; however, due to fracture displacement progression and subsequent reinjury from a fall, surgical intervention became necessary, requiring acetabular reconstruction and implant revision. Treatment options for PPAF include conservative management, plate fixation, and implant revision. In many cases, early surgical intervention yields better outcomes. Therefore, close collaboration between orthopedic trauma surgeons and hip reconstruction specialists is essential. Given the limited number of reported cases, further accumulation of case data and evaluation of long-term outcomes are needed. Early classification and appropriate management are crucial for optimal treatment of PPAF.