Related Experiment Video
Updated: Jan 24, 2026
Dosage-Adjusted Resistance Training in Mice with a Reduced Risk of Muscle Damage
Published on: August 31, 2022
Electrocautery Damage Can Reduce Implant Fatigue Strength: Cases and in Vitro Investigation
Robert Sonntag1, Jens Gibmeier2, Samuel Pulvermacher2
1Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Background:
The risk of femoral stem fracture after total hip replacement is low and can often be associated with a specific implant system or other factors that may reduce the fatigue strength. Additionally, damage to a metal component during revision surgery by an electrocautery device may further affect the fatigue behavior.
Methods:
Two clinical cases of stem failure after revision of fractured ceramic components are presented; the retrieved components were analyzed for the cause of failure. In vitro cyclic load-to-failure testing of titanium alloy femoral stems after electrocautery application at 2 different locations (at the base and about midway on the femoral neck) was performed using a stepwise increase in load until implant fracture occurred. In addition, a detailed characterization of the local material structure around the electrocautery marks was performed.
Results:
Superficial discoloration and melting marks were found on the retrieved components, including at the location of crack initiation in the anterolateral region, which may have reduced the fatigue strength of the material. In addition, elemental analysis indicated material transfer from the electrocautery tip. Damage to the surface by the electrocautery device significantly reduced the in vitro load to failure by up to 47% compared with that of undamaged femoral neck specimens. Material analysis revealed a relevant modification in microstructure, with an extension of approximately 2.7 mm and a depth of 550 µm, which could be divided in 3 structural zones.
Conclusions:
Intraoperative electrocautery device contact with the implant during surgical revision of a total hip replacement cannot always be avoided. However, on the basis of our findings, the risk of implant failure is increased due to a change in microstructure and a potential reduction of the implant's fatigue strength. Surgeons and manufacturers of electrocautery devices should be aware of this concern.
Clinical Relevance:
During revision surgery, contact between an electrocautery device and the femoral component should be avoided to reduce the chance of subsequent femoral neck fracture.
More Related Videos
Related Concept Videos
01:22Fatigue Strength of Concrete
01:21Fatigue
03:05Acid Strength and Molecular Structure
In the absence of any leveling effect, the acid strength of binary compounds of hydrogen with nonmetals (A) increases as the H-A bond strength decreases down a group in the periodic table. For group 17, the order of increasing acidity is HF < HCl < HBr < HI. Likewise, for group 16, the order of increasing acid strength is H2O < H2S < H2Se < H2Te. Across a row in the periodic table, the acid strength of binary hydrogen compounds increases with increasing...
01:20Strength of Cement
For compressive strength tests, ASTM C 109-05 standards prescribe a cement-sand mix ratio of 1:2.75 and a water/cement ratio of 0.485 for making 2-inch cubes. These cubes are mixed, cast, and cured in saturated lime water at 23°C until testing. Flexural strength testing, outlined in...
01:30Relation Between Tensile Strength and Compressive Strength of Concrete
02:18The Equilibrium Binding Constant and Binding Strength