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Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands

INTRODUCTION: Fracture of stems in primary total hip arthroplasty is a known complication and has been attributed to varus positioning, excessive weight of the patient, resorption of the femoral calcar and failure of the cement mantle. Fractures in uncemented revision femoral stems are rare and are...

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Autores principales: Merchant, Rajiv, Kelly, Ian, Quinlan, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719260/
https://www.ncbi.nlm.nih.gov/pubmed/27298992
http://dx.doi.org/10.13107/jocr.2250-0685.215
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author Merchant, Rajiv
Kelly, Ian
Quinlan, John
author_facet Merchant, Rajiv
Kelly, Ian
Quinlan, John
author_sort Merchant, Rajiv
collection PubMed
description INTRODUCTION: Fracture of stems in primary total hip arthroplasty is a known complication and has been attributed to varus positioning, excessive weight of the patient, resorption of the femoral calcar and failure of the cement mantle. Fractures in uncemented revision femoral stems are rare and are attributed to reduction in proximal support either in the form of bone loss or an extended trochanteric osteotomy [ETO] against a distally well- fixed stem. Also, undersized stems and high BMI to increase the risk of stem fracture. CASE REPORT: We report 3 cases of uncemented revision stem fractures. Case 1 is a 77 year old male, Case 2 is a 71- year-old female, case 3 an 82-year-old male. All three patients had significant proximal femoral osteolysis. All three had an extended trochanteric osteotomy for the revision surgery. The hips had remained in-situ for 4, 2 and 5 years respectively prior to fracture. CONCLUSION: When planning complex revision cases involving long uncemented stems, attention should be given to the above-mentioned variables. ETO non-union and proximal bone loss play an important role in stem fractures. Stem failure can occur irrespective of the make, and factors such as adequate stem size and good diaphyseal fit are non negotiable.
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spelling pubmed-47192602016-06-13 Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands Merchant, Rajiv Kelly, Ian Quinlan, John J Orthop Case Reports Case Report INTRODUCTION: Fracture of stems in primary total hip arthroplasty is a known complication and has been attributed to varus positioning, excessive weight of the patient, resorption of the femoral calcar and failure of the cement mantle. Fractures in uncemented revision femoral stems are rare and are attributed to reduction in proximal support either in the form of bone loss or an extended trochanteric osteotomy [ETO] against a distally well- fixed stem. Also, undersized stems and high BMI to increase the risk of stem fracture. CASE REPORT: We report 3 cases of uncemented revision stem fractures. Case 1 is a 77 year old male, Case 2 is a 71- year-old female, case 3 an 82-year-old male. All three patients had significant proximal femoral osteolysis. All three had an extended trochanteric osteotomy for the revision surgery. The hips had remained in-situ for 4, 2 and 5 years respectively prior to fracture. CONCLUSION: When planning complex revision cases involving long uncemented stems, attention should be given to the above-mentioned variables. ETO non-union and proximal bone loss play an important role in stem fractures. Stem failure can occur irrespective of the make, and factors such as adequate stem size and good diaphyseal fit are non negotiable. Indian Orthopaedic Research Group 2014 /pmc/articles/PMC4719260/ /pubmed/27298992 http://dx.doi.org/10.13107/jocr.2250-0685.215 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-sa/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Merchant, Rajiv
Kelly, Ian
Quinlan, John
Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title_full Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title_fullStr Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title_full_unstemmed Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title_short Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands
title_sort fracture of uncemented revision femoral stems in three arthroplasty patients: a case series with three different brands
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719260/
https://www.ncbi.nlm.nih.gov/pubmed/27298992
http://dx.doi.org/10.13107/jocr.2250-0685.215
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