title: Conversion of a long distally fixed uncemented revision femoral stem to a proximally fixed implant following fatigue fracture.
abstract: There has been increasing focus on bone conservation through proximal fixation in primary hip arthroplasty. However, the debate regarding fixation in revision arthroplasty and which factors influence implant choice remains less clear-cut. We report a case involving fatigue fracture of a long, distally well-fixed, uncemented revision stem. This was revised to a proximally fixed implant. This case highlights a number of issues when considering the choice of implant in hip revision surgery and raises the issue of bone conservation in revision surgery. We would suggest that in both primary and revision hip arthroplasty meticulous pre-operative consideration of the choice of implant should be undertaken, especially in the younger patient with higher expectations and functional demands.
authors.affiliation: Department of Orthopaedics and Trauma, Pilgrim Hospital, Boston, UK. peteryoung2@nhs.net
authors.forename: Peter S
authors.initials: PS
authors.lastname: Young
authors.forename: Rory G
authors.initials: RG
authors.lastname: Middleton
authors.forename: Ian D
authors.initials: ID
authors.lastname: Learmonth
authors.forename: Tahawwar Hasnat A
authors.initials: TH
authors.lastname: Minhas
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002484:Cementation; D005269:Femur / Q000601:surgery*; D015775:Fractures, Stress / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome