The incidence and complexity of the femoral fracture around a previously implanted prosthetic component has been increasing over the last ten years, and treatment can be complex, expensive and associated with an increased risk of local and systemic complications. The surgical treatment options for periprosthetic fractures include open reduction and internal fixation of bone or revision arthroplasty. This review focuses on the current surgical techniques and the pharmacological therapy to provide biological support for the enhancement of bone healing.