Analyses of prosthesis stem failures in noncemented modular hip revision prostheses

The Journal of Arthroplasty
Turgay Efe, Jan Schmitt

Abstract

In recent years, hip prosthesis stem revision by means of modular revision systems has reached an essential role in revision prosthetics. It is an extremely successful technique. Reports about mechanical failure in nonmodular revision stems have already been published. This complication is rare, but feared. We report about mechanical failure of four non-cemented modular revision stems over a period of 28 months. All failures became clinically apparent because of severe inguinal or thigh pain and were confirmed by conventional x-ray imaging. All stem failures occurred just below the interface between prosthesis stem and neck, which is a biomechanically stressed area. Distal of the failure, all stems were still firmly fixed. In all cases, there was obvious evidence of loosening at the proximal component. Metallographic and energy-dispensive x-ray analysis of one stem showed a fatigue fracture due to dynamic stress. If new pain arises after revision surgery with modular non-cemented prosthesis systems, the possibility of an implant failure should be kept in mind. Patients should be informed accordingly about the risk of implant failure.

References

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Citations

Jun 3, 2014·Journal of Medical Case Reports·Goran BicanicDomagoj Delimar
Jul 1, 2014·The Orthopedic Clinics of North America·Antonia F Chen, William J Hozack
Apr 19, 2017·Materials Science & Engineering. C, Materials for Biological Applications·Yoshimitsu OkazakiAtsushi Ogawa
May 17, 2017·The Journal of Bone and Joint Surgery. American Volume·Matthew P AbdelDaniel J Berry
Apr 5, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Mark S RickmanMichelle Lorimer
Aug 25, 2011·Clinical Orthopaedics and Related Research·Letitia LimMichael Tanzer
Dec 14, 2019·Journal of Orthopaedic Surgery·Celso Hermínio Ferraz PicadoFlávio Luís Garcia
Apr 18, 2019·The Journal of Bone and Joint Surgery. American Volume·Michael J DeRogatisPaul S Issack
May 1, 2020·The Bone & Joint Journal·D R KruegerC Perka
Jul 19, 2018·Case Reports in Orthopedics·Falko Herold, Henk Eijer
Oct 24, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Falko HeroldHenk Eijer
Apr 9, 2021·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Antonios A KoutalosTheofilos Karachalios

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