Introducing the Universal Periprosthetic Femur Fracture (UPFF) Classification: All Fractures Femur

Journal article

Peri-Prosthetic Femur Fractures (PPFFs) are occurring with increasing frequency as the incidence of hip and knee arthroplasty is rising globally. PPFFs are presenting with more complex patterns commensurate with the increasing sophistication of implant technology and surgical technique. Moreover, with patients undergoing arthroplasty procedures at a younger mean age, it is not uncommon to see both ipsilateral implants (hip and knee) being affected by the fracture. Previous classifications have separated PPFFs into the hip or knee regions, and most do not include fracture patterns about revision-style implants. Prior schemes are antiquated and are not applicable to all current fracture patterns. We present a codified anthropometric, rule-based staging system that incorporates PPFFs across the entire femur. This system is designed to standardize communication and capture variables relevant to treatment planning and future research analysis. Formal reliability and clinical validation studies are ongoing.

Authors: McPherson, EJ; Chowdhry, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: MDPI
• Journal: Journal of Clinical Medicine
• Volume: 15
• Issue: 5
• Pages: 1824
• Article number: 1824
• Publication date: 2026-02-27
• Acceptance date: 2026-02-23
• DOI: 10.3390/jcm15051824
• EISSN: 2077-0383
• ISSN: 2077-0383
• Language: English
• Keywords: hip; arthroplasty; knee; classification; periprosthetic; trauma; fracture; femur