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Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?

The fracturing of a hip prosthesis stem at its neck, in the absence of a trauma, is an extremely rare but serious adverse event. The patient in our case was young, active, and tall, thereby putting high mechanical loads on the prosthesis. Radiographs of the initial procedure and blood and synovium a...

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Autores principales: Jeuken, Ralph M., Fransz, Duncan P., Geers, Marc G.D., van Maris, Marc P.F.H.L., ten Broeke, René H.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551419/
https://www.ncbi.nlm.nih.gov/pubmed/34746345
http://dx.doi.org/10.1016/j.artd.2021.07.016
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author Jeuken, Ralph M.
Fransz, Duncan P.
Geers, Marc G.D.
van Maris, Marc P.F.H.L.
ten Broeke, René H.M.
author_facet Jeuken, Ralph M.
Fransz, Duncan P.
Geers, Marc G.D.
van Maris, Marc P.F.H.L.
ten Broeke, René H.M.
author_sort Jeuken, Ralph M.
collection PubMed
description The fracturing of a hip prosthesis stem at its neck, in the absence of a trauma, is an extremely rare but serious adverse event. The patient in our case was young, active, and tall, thereby putting high mechanical loads on the prosthesis. Radiographs of the initial procedure and blood and synovium analysis showed no abnormalities. Analysis of the stem revealed niobium-rich precipitates, that is, alloy artifacts, at the introducer stud hole. The mechanically vulnerable location of the introducer stud hole, combined with alloy artifacts at that location and high mechanical stress, ultimately led to failure of the prosthesis. As younger and heavier patients will demand hip arthroplasty in the future, simple stem design adaptations should be considered to prevent stem fractures at the introducer stud hole.
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spelling pubmed-85514192021-11-04 Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change? Jeuken, Ralph M. Fransz, Duncan P. Geers, Marc G.D. van Maris, Marc P.F.H.L. ten Broeke, René H.M. Arthroplast Today Case Report The fracturing of a hip prosthesis stem at its neck, in the absence of a trauma, is an extremely rare but serious adverse event. The patient in our case was young, active, and tall, thereby putting high mechanical loads on the prosthesis. Radiographs of the initial procedure and blood and synovium analysis showed no abnormalities. Analysis of the stem revealed niobium-rich precipitates, that is, alloy artifacts, at the introducer stud hole. The mechanically vulnerable location of the introducer stud hole, combined with alloy artifacts at that location and high mechanical stress, ultimately led to failure of the prosthesis. As younger and heavier patients will demand hip arthroplasty in the future, simple stem design adaptations should be considered to prevent stem fractures at the introducer stud hole. Elsevier 2021-10-04 /pmc/articles/PMC8551419/ /pubmed/34746345 http://dx.doi.org/10.1016/j.artd.2021.07.016 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Jeuken, Ralph M.
Fransz, Duncan P.
Geers, Marc G.D.
van Maris, Marc P.F.H.L.
ten Broeke, René H.M.
Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title_full Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title_fullStr Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title_full_unstemmed Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title_short Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?
title_sort failure mode analysis of an exeter stem fracture initiated at the introducer hole: time for a design change?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551419/
https://www.ncbi.nlm.nih.gov/pubmed/34746345
http://dx.doi.org/10.1016/j.artd.2021.07.016
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