Mondanelli N, Facchini A, Troiano E, et al. - This study was undertaken to investigate in a single Institution series of periprosthetic femoral fractures (PFFs) whether any of them could be considered a periprosthetic atypical femoral fracture (PAFF), and their prevalence. Between January 2013 and December 2019, researchers searched surgical records for PFFs around a primary hip stem. They categorized cases according to Vancouver classification. For statistical analysis, Fisher’s exact test was applied. They distinguished 115 PFFs, 59 of them were type B1 and 16 were type C. The results demonstrated that fracture with characteristics of AFFs can also happen over a prosthetic stem, configuring themselves as PAFFs, and they are related to prolonged bisphosphonates use. A revision of criteria for AFFs should be considered, accepting that PAFFs exist, as a correct diagnosis is mandatory for proper treatment.