Rupture of Extensively Porous Coated Stems. - A Case Series of 2 Patients

Mechanical failure of femoral stems of revision hip arthroplasty has been rarely reported. In the current study, the cause of two stem fractures, which occurred in vivo, was analysed with use of clinical and radiological data, and the functional result after revision is presented.

Two patients, A 70-year-old male and a 73-year-old female, both of Mediterranean ethnic, and both patients underwent a revision total hip replacement to an uncemmented extensively porous coated stem. Both stems suffered an implant fatigue in vivo at three years and at two years follow-up respectively.

Revision total hip arthroplasty is a procedure that will be performed more often the following years due to aging of population. Any orthopaedic surgeon performing hip surgery should be aware of the risk factors that can lead to total hip arthroplasty failure. In the analysed cases we can learn that the main factors related to this failure included the use of a small size stem (inferior to 14mm), an inadequate proximal osseous support because of trochanteric osteotomy, and a reduced preoperative bone stock. Although the use of cables has not been stated as a predisposing factor, we consider that they could also play a role in the development of this rare complication.