title: Fracture of fully coated echelon femoral stems in revision total hip arthroplasty.
abstract: Three cases of fractured uncemented, fully porous Echelon femoral stems (Smith & Nephew, Memphis, Tenn) are examined. Fracture of these components, an uncommon complication of revision hip surgery, is thought to result from cantilever bending after distal bony ingrowth. The stems in these cases fractured at 11, 22, and 28 months after revision surgery. Risk factors include increased body weight, excessive activity, an undersized stem, varus alignment, inadequate proximal femoral bone stock, and metallurgic defects. Extraction can be difficult and is often accomplished with the use of multiple trephines or via tamping through a distal cortical window.
authors.affiliation: NYU Hospital for Joint Diseases Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Landa
authors.forename: Michael
authors.initials: M
authors.lastname: Benke
authors.forename: Alan
authors.initials: A
authors.lastname: Dayan
authors.forename: Gavin
authors.initials: G
authors.lastname: Pereira
authors.forename: Paul E
authors.initials: PE
authors.lastname: Di Cesare
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001835:Body Weight; D017760:Bone Malalignment; D002858:Chromium Alloys; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors
chemical_list: D002858:Chromium Alloys