González-Martín D, Pais-Brito JL, Casamayor SG, et al. - This study sought to correlate stem revision vs internal fixation in the treatment of periprosthetic hip fractures (PPHF) with a loose stem. Researchers evaluated hospital stay, American Society of Anesthesiologists, Charlson comorbidity index, surgery time, blood transfusion, complications, reoperation rate, first-year mortality, radiological, and functional results. The study enrolled a sum of 57 patients (40 osteosyntheses and 17 stem revision), with an average follow-up time of 3.1 years. The results showed that osteosynthesis needs less surgery time, has a lower need for blood transfusions, and a reduced hospital cost in comparison with stem revision. This study’s findings suggested that stem revision remains the treatment of choice in PPHF with a loose stem, but in V-B2 fractures in elderly patients with low functional demand, high anesthetic risk, and many comorbidities in whom anatomic reconstruction is possible, osteosynthesis can be a viable option.