Title

Implant fracture after long-stemmed cemented hemiarthroplasty for oncologic indications

Document Type

Journal Article

Publication Date

6-26-2015

Journal

Journal of Long-Term Effects of Medical Implants

Volume

25

Issue

3

DOI

10.1615/JLongTermEffMedImplants.2014010812

Keywords

Fatigue fracture; Hemiarthroplasty; Implant fai; K long-stemmed cemented

Abstract

© 2015 by Begell House, Inc. Although a long-stemmed cemented hemiarthroplasty is frequently recommended for oncologic lesions of proximal femur, we have observed an alarming number of spontaneous stem fractures. The purpose of this retrospective study was to identify the associated risk factors for stem fractures in a study cohort of 60 (61 prostheses) during 1983–2007. At a mean follow-up of 41 months, 4/61 (6.6%) stems had fractured after a mean of 36 (12–92) months after surgery. All failed implants were Osteonics Omnifit (4/27; 14.8%) and multivariate analysis did not show any correlation with other studied variables. While the failures were successfully salvaged by conversion to a modular proximal femoral replacement, any implant failure in this population is devastating. Spontaneous onset of thigh pain in patients with long stems, particularly if associated with other risk factors, should raise suspicion of a fatigue fracture of the stem.

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