title: Fracture of the hydroxyapatite-ceramic-coated JRI-Furlong femoral component: body mass index and implications for selection of the implant.
abstract: We describe three cases of fracture of the titanium JRI-Furlong hydroxyapatite-ceramic (HAC)-coated femoral component. We have examined previous case reports of failure of this stem and conclude that fracture may occur in two places, namely at the neck-shoulder junction and at the conical-distal cylindrical junction. These breakages are the result of fatigue in a metallurgically-proven normal femoral component. All the cases of failure of the femoral component have occurred in patients with a body mass index of more than 25 in whom a small component, either size 9 or 10, had been used. In patients with a body mass index above normal size 9 components should be avoided and the femoral canal should be reamed sufficiently to accept a large femoral component to ensure that there is adequate metaphyseal fixation.
authors.affiliation: Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK. harvie1@tiscali.co.uk
authors.forename: P
authors.initials: P
authors.lastname: Harvie
authors.forename: M
authors.initials: M
authors.lastname: Haroon
authors.forename: N
authors.initials: N
authors.lastname: Henderson
authors.forename: M
authors.initials: M
authors.lastname: El-Guindi
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D015992:Body Mass Index; D002516:Ceramics; D017886:Durapatite; D019544:Equipment Failure Analysis; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D014025:Titanium
chemical_list: D017886:Durapatite; D014025:Titanium