BACKGROUND Both increasing implantation numbers of total hip replacements and demographic change with higher populations of older people, indicate that there will be an increase in periprosthetic fractures in the future. METHODS Falls in the home environment are the most common cause. Significant co-factors include reduced patient coordination, reduced bone quality, or implant-associated factors such as local osteolysis or pre-existing implant loosening. METHODS In the classification of periprosthetic fractures of the femur, the Vancouver classification has prevailed in recent years, which in addition to a description of the localization of the fracture also considers the stability of the prosthesis and bone quality. Based on this, therapeutic algorithms have been developed that can vary from the conservative approach via osteosynthetic options to a replacement of the prosthesis. In order to allow the description of periprosthetic fractures on all joints, the Vancouver classification has been extended to the UCS classification by including the AO/OTA bone and joint coding system. In the selection of the treatment method, the consideration of individual patient factors such as activity level and secondary diagnoses is essential. Based on the established classifications, the importance of the different therapeutic methods is presented.