Preoperative functional assessment

The history, examination, and radiological assessment of a patient with a periprosthetic fracture follows the standard clinical practice and aims to determine the following:

• What the original intervention(s) aimed to achieve (based on the original diagnosis) and how it was executed
• What, if any, postoperative problems were encountered
• The timeline of symptoms following the primary arthroplasty
• A working diagnosis of the fracture and prosthesis
• The patient’s assessment of functional decrement and the impact of pain on their life

Patient-related outcome measures are valuable in assessing the functional decrement and impact on daily life. These measures help to comprehend the patient’s goals. The prognosis for surgical intervention is determined by a comparison between the patient’s goals and the potential of a surgical intervention to meet those goals.

After further investigations including imaging and special tests for infection the following become clear:

• What potential options are available for management of the fracture
• The risks and barriers to achieving the desired outcome and at what level of achievement this is likely to be
• What strategies are needed for successful restoration of the soft tissues and revision of the arthroplasty components if indicated