Case report: Cementless stem stabilization after intraoperative fracture: a radiostereometric analysis

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Radiostereometry

Background:

• Intraoperative femoral fractures are a known complication during total hip arthroplasty (THA).
• Management of these fractures often involves specific fixation techniques and implant choices.
• Hydroxyapatite-coated cementless stems are utilized for improved osseointegration.

Observation:

• A patient sustained an intraoperative femoral fracture during THA.
• The fracture was managed with cerclage fixation and implantation of an hydroxyapatite-coated cementless stem.
• Postoperative radiostereometry tracked stem migration over two years.

Findings:

• Significant subsidence and rotation of the femoral stem were observed initially.
• Despite initial instability, the stem achieved stabilization by the six-month postoperative mark.
• The hydroxyapatite-coated cementless stem demonstrated successful clinical outcomes in the presence of intraoperative fracture.

Implications:

• This case highlights the potential for successful clinical outcomes even with intraoperative femoral fractures during THA.
• The use of hydroxyapatite-coated cementless stems may offer a viable solution for managing such complications.
• Understanding stem migration patterns is crucial for predicting long-term stability after fracture fixation in THA.