[Damage to implants due to high-frequency electrocautery : analysis of four fractured hip endoprostheses shafts]

In revision surgery of joints, high-frequency electrocauterization instruments are used for homeostasis and dissection of soft tissue. If there is contact of these instruments with the metal implants, flashover can occur. This can lead to thermal microstructural changes in the material and as a consequence may reduce the fatigue strength of the implant. Four cases of hip revision surgeries were analysed. In all cases flashovers occurred and secondarily, the titanium hip endoprosthesis stem broke in the neck section of the prosthesis. The conducted investigations showed that contact between the high-frequency instrument and the anterolateral aspect of the endoprosthesis neck had occurred. Electrothermal implant damage was found in the broken area. If in hip revision surgery the stem is not to be replaced, contact between high-frequency instruments and the metal implant should be avoided.