Fractures at the tip of long-stem prostheses used for revision hip arthroplasty.
We report a retrospective analysis of the incidence of intraoperative femur fractures at the tip of the prosthesis in 45 consecutive, uncemented, long (205-mm), straight hydroxyapatite, fully coated stems used for revision arthroplasty of the hip. Five patients were lost to follow-up. Intraoperative fractures of the distal femur occurred in 7 cases (17.5%). In the remaining 33 cases in which no fracture occurred, the tip of the implanted stem was found to be potentially at risk for causing a fracture in 18 (55%) cases. We concluded that uncemented, 205-mm, straight femoral stems should be used with caution in the setting of revision hip surgery. A bowed stem of that length may be a safer alternative. Otherwise, a shorter, straight stem may reduce the risk of complications at the stem tip.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020099:Coated Materials, Biocompatible; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies
D020099:Coated Materials, Biocompatible