Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Mar 7;5(1):52-56.
doi: 10.1016/j.artd.2019.01.006. eCollection 2019 Mar.

Fracture of the neck of an uncemented femoral component unrelated to trunnion corrosion

Jonathan R Peterson  1 , Timothy M Wright  2 , Samuel S Wellman  1 , Paul F Lachiewicz  1
Affiliations
Case Reports

Fracture of the neck of an uncemented femoral component unrelated to trunnion corrosion

Jonathan R Peterson et al. Arthroplast Today. .

Abstract

This is the first report, to our knowledge, of a fracture, unrelated to trunnion corrosion, through the midneck of a well-fixed uncemented cobalt-chromium alloy femoral component that had been implanted via a total hip revision arthroplasty 25 years ago. Three years after a second revision for polyethylene wear, the patient noted an acute onset of pain in the left hip. There was no antecedent pain in the hip or thigh. Radiographs and intraoperative findings showed a well-fixed femoral component. Electron microscopic retrieval analysis showed intergranular material cracks. Revision of the femoral component was performed with an extended trochanteric osteotomy. This fracture of the femoral component neck was likely related to metal fabrication techniques, and surveillance of this component may be warranted.

Keywords: Catastrophic failure; Femoral component neck fracture; Revision; Total hip arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Anteroposterior (a) and lateral (b) radiographs of the left hip before head and liner exchange. Radiographs demonstrate polyethylene wear and osteolysis in the greater trochanter.
Figure 2
Figure 2
Anteroposterior (a) and oblique lateral (b) radiographs of the left hip on the day of injury, with fracture through the neck of the femoral component.
Figure 3
Figure 3
Anteroposterior (a) and lateral (b) radiographs of the left hip at 3 months postoperatively. Radiographs demonstrate healing of the osteotomy site and stable positioning of the components.
Figure 4
Figure 4
Macroscopic photograph (a) of the fractured implant demonstrating typical fracture between the grains of the Co-Cr casting that resembles a series of up and down pyramids. Electron microscopy image (b) demonstrating additional intergranular cracks besides the one that formed the main fracture (arrow heads). Co-Cr, cobalt-chromium.
See this image and copyright information in PMC

References

    1. Spanyer J., Hines J., Beaumont C.M., Yerasimides J. Catastrophic femoral neck failure after THA with the accolade((R)) I stem in three patients. Clin Orthop Relat Res. 2016;474:1333. - PMC - PubMed
    1. Bozic K.J., Kurtz S.M., Lau E. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128. - PubMed
    1. Charnley J. Fracture of femoral prostheses in total hip replacement. A clinical study. Clin Orthop Relat Res. 1975;111:105. - PubMed
    1. Heck D.A., Partridge C.M., Reuben J.D. Prosthetic component failures in hip arthroplasty surgery. J Arthroplasty. 1995;10:575. - PubMed
    1. Martens M., Aernoudt E., de Meester P. Factors in the mechanical failure of the femoral component in total hip prosthesis. Report of six fatigue fractures of the femoral stem and results of experimental loading tests. Acta Orthop Scand. 1974;45:693. - PubMed

Publication types

LinkOut - more resources