title: Femoral perforation complicating contemporary uncemented hip arthroplasty.
abstract: This case series reports on 4 patients in whom intraoperative penetration of the femoral cortex occurred and went unrecognized on routine postoperative radiographs. This case series highlights some important points. Femoral cortex penetration can and does occur with uncemented hip arthroplasty and is likely to occur when surgical exposure is difficult and inadequate (such as in patients with severe obesity) or some form of proximal femoral deformity exists (such as patients with achondroplasia). Extra diligence should be exercised to avoid this complication in the high-risk patients, and adequate 2-plain radiographs may need to be ordered intraoperatively if such complication is suspected.
authors.affiliation: Department of Orthopedic Surgery, Rothman Institute at Thomas Jefferson Hospital, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Frazer A
authors.initials: FA
authors.lastname: Wade
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Peter F
authors.initials: PF
authors.lastname: Sharkey
authors.forename: James J
authors.initials: JJ
authors.lastname: Purtill
authors.forename: William J
authors.initials: WJ
authors.lastname: Hozack
mesh_terms: D000130:Achondroplasia / Q000453:epidemiology; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000293:injuries*; D006622:Hip Prosthesis; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015207:Osteoarthritis, Hip / Q000453:epidemiology / Q000601:surgery; D011859:Radiography; D012307:Risk Factors