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Updated: Mar 14, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Spontaneous Fractures of a Modern Modular Uncemented Femoral Stem
Chelsea N Koch1, Laura Serrano Mateo2, Stephen Kayiaros3
1Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Background:
Femoral stem fracture following total hip arthroplasty is an uncommon event that requires immediate revision surgery.
Questions/Purposes:
We report on four patients who experienced stem fractures of one design and a review of the US Food and Drug Administration adverse event reports on this design.
Methods:
Fracture surfaces of four EMPERION™ (Smith & Nephew, Memphis, TN) femoral stems were analyzed under optical and scanning electron microscopy. A search of the FDA's Manufacturer and User Facility Device Experience (MAUDE) that reports on all EMPERION™ adverse events was completed.
Results:
Fracture surfaces exhibited characteristics consistent with a fatigue fracture mechanism. Sixteen MAUDE reports claimed stem fracture or breakage of EMPERION™ stems.
Conclusion:
The four cases of EMPERION™ stem fractures were likely driven by small stem diameter, high offset, and high patient weight. Modular stem-sleeve femoral systems are susceptible to fatigue failure under high stress and should only be used in appropriate patients, whom are not considered obese.
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