title: Treatment of a well-fixed modular fully porous coated stem after fracture using a custom rescue sleeve.
abstract: We report a novel technique for the treatment of a fractured fully porous-coated modular stem. The fracture of the stem occurred at the taper of the stem-body junction. In both cases, the stem was well-fixed distally making the reconstruction difficult. Previously, authors have reported the use of an extended trochanteric osteotomy or multiple cortical windows for removal of this type of prosthesis. The technique we describe uses a custom-made "rescue sleeve" that takes advantage of the distal ingrowth. The rescue sleeve is fitted onto the existing stem obviating the need for an extended trochanteric osteotomy. The rescue sleeve's geometry makes up for the loss in height and accepts the modular body components to give the surgeon the length options to optimize stability.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Beal
authors.forename: Anthony
authors.initials: A
authors.lastname: Marchie
authors.forename: Eric
authors.initials: E
authors.lastname: Black
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.forename: Dennis
authors.initials: D
authors.lastname: Burke
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D004868:Equipment Failure; D005269:Femur / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy; D011474:Prosthesis Design