Intraoperative Fracture of the Femur in Revision Total Hip Arthroplasty with a Fully HA-Coated Stem

Abstract

A retrospective review was made of intraoperative femoral fracture prevalence in seventy nine consecutive, cementless, fully HA-coated stems used for revision hip arthroplasty. Three patients were lost to follow up. Intraoperative fracture occurred in 15 (20%) femurs. Fractures occurred during cement removal (3/15) or insertion of the implant (12/15). All fractures were identified using intraoperative biplane X-ray, and were treated during the same operation. The clinical outcome of both groups (with or without fractures) was similar. The risk of intraoperative fracture was not statistically related to any demographic features or operative technique. Intraoperative radiographs are therefore mandatory in revision hip arthroplasty in order to diagnose and treat the common complication of femur fracture appropriately.

Extensively hydroxyapatite-coated long femoral stem revision hip arthroplasty: Clinical outcome and survivorship in 11 to 17.5 years follow up

“…Concerning the complications, complication of eccentric reaming, femoral perforation and femoral fracture using extensively porous-coated femoral stem reported by Issack et al was 0.1%, 6 and the intraoperative fracture of femur in revision total hip arthroplasty with a fully hydroxyapatite-coated stem reported by Rothem et al was 20%. 12 Our study showed a higher intraoperative femur fracture of 27.9%. However, 25.6% of the intraoperative fracture occurred during removal of old implants and the cement (if any) which was not related to what type of new femoral stem used.…”