Novel Strategy for Incarcerated Broken Broach Retrieval in Total Hip Arthroplasty

The goal of femoral component positioning in cementless total hip arthroplasty (THA) is accurate restoration of joint biomechanics and a press fit between the implant and the endosteal surface of the proximal femur. We present a case detailing an intraoperative broach fracture during THA and introduce a minimally invasive technique for broach removal.

A 45-year-old male with left hip osteoarthritis underwent left THA, and the final broach fractured during the extraction attempt. Given the hole in the proximal part of the broach's shoulder, we created a cortical window near the proximal femur to expose the defect. The successful extraction was accomplished using a Kuntscher nail extractor.

Notably, this technique resulted in no morbidity and eliminated the necessity for extending the approach or additional soft-tissue dissection.Surgeons performing THA must be prepared for unexpected challenges and possess the necessary skills to address complications. This report presents a case of femoral broach fracture during THA and describes an effective, economical, and safe solution to resolve the issue.