title: Unexpected finding of a fractured metal prosthetic femoral head in a nonmodular implant during revision total hip arthroplasty.
abstract: Though there are many reports of fractured femoral components after total hip arthroplasty; there are no reports of a fractured metal femoral head. This is a report of a fractured metal femoral head in a nonmodular total hip replacement discovered unexpectedly during revision total hip arthroplasty for acetabular failure. This surprise finding, which was not appreciated on preoperative x-rays, required unplanned extraction of a well-ingrown, fully porous coated cylindrical femoral stem. Though rare, fracture of the metal femoral head in a DePuy (Warsaw, Ind.) monoblock Anatomic Medullary Locking (AML) component is possible, and one cannot expect the fracture to be apparent on preoperative radiographs as the 2 pieces may not necessarily dissociate. As usual, the surgeon performing revision arthroplasty should be prepared to revise all components.
authors.affiliation: Department of Orthopedic Surgery (112), VA Palo Alto Healthcare System, Palo Alto, CA 94305, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Giori
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001672:Biocompatible Materials; D019544:Equipment Failure Analysis; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation
chemical_list: D001672:Biocompatible Materials; D008670:Metals