Total hip replacements (THR) with modular femoral components (stem-neck interface) make it possible to adapt to extramedullary femoral parameters (anteversion, offset, and length) theoretically improving muscle function and stability. Nevertheless, adding a new interface has its disadvantages: reduced mechanical resistance, fretting corrosion and material fatigue fracture. We report the case of a femoral stem fracture of the female part of the component where the modular morse taper of the neck is inserted. An extended trochanteric osteotomy was necessary during revision surgery because the femoral stump could not be grasped for extraction, so that a long stem had to be used. In this case, the patient had the usual risk factors for modular neck failure: he was an active overweight male patient with a long varus neck. This report shows that the female part of the stem of a small femoral component may also be at increased failure risk and should be added to the list of risk factors. To our knowledge, this is the first reported case of this type of failure.

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Deltoid palsy is a classical contraindication for reverse shoulder arthroplasty (RSA). However, in cases associating axillary nerve palsy and rotator cuff tear or glenohumeral arthritis, few options remain. We present a case in which combining RSA with transfer of the pectoralis major and upper and middle trapezius transfer provided satisfactory results in a patient suffering of both an irreparable rotator cuff tear and a deltoid palsy.Level of evidence IV.