Summary
Thirteen failed stem of Total Hip Replacement were studied: 9 were Charnley THR from an homogeneous series, which gives an incidence of 2.4% of stem fractures with a follow-up of 9–16 years; 4 were Mueller THR. Fatigue fracture of the stem occurred by defective support of the proximal part of the femur, following resorption of the calcar. In all cases reactive tissue to foreign body particles, metal and polyethylene, was found where bone resorption occurred. In Mueller THR wear of the cup produced the large amount of polyethylene particles; in Charnley THR metal particles prevailed and corrosion of the stem is suggested to be the initiating factor.
Similar content being viewed by others
References
Carlsson AS, Gents CF, Stenport J (1977) Fracture of the femoral prosthesis in hip replacement according to Charnley. Acta Orthop Scand 48:650–655
Chao EYS, Coventry MB (1981) Fracture of the femoral component after total hip replacement. J Bone Joint Surg [Am] 63:1078–1094
Charnley J (1975) Fracture of femoral prostheses in total hip replacement. Clin Orthop 111:105–120
Collis DK (1977) Femoral stem failure in total hip replacement. J Bone Joint Surg [Am] 59:1033–1041
Dobbs HS, Scales JT (1979) Fracture and corrosion in stainless steel total hip replacement stem. In: Syrett BC, Acharya A (eds) Corrosion and degradation of implanted materials. ASTM STP 684. American Society for Testing and Materials, pp 254–258
Ducheyne P, De Meester P, Aernoud E (1975) Fatigue fractures of the femoral component of Charnley and Charnley-Mueller type total hip prostheses. J Biomed Mat Res (Symp) 6:199–219
Fornasier VL, Cameron HU (1976) The femoral stem-cement interface in total hip replacement. Clin Orthop 116:248–252
Galante JO (1980) Causes of fracture of the femoral component in total hip replacement. J Bone Joint Surg [Am] 62:670–673
Galante JO, Rostocker W, Doyle JM (1975) Failed femoral stems in total hip prostheses. J Bone Joint Surg [Am] 57:230–236
Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components. Clin Orthop 141:17–27
Jaeger JH, Glaesener R, Briot B, Kempf I, Nessius A, Mondoloni JL (1974) Ropture en service des arthroplasties totales de hanche au niveau de la piece femorale. Acta Orthop Belg 40:861–876
Lee AJC, Ling RSM, Vangala SS (1978) Some clinical variables affecting the mechanical behaviour of bone cement. Arch Orthop Trauma Surg 92:1–18
Martens M, Aernoudt E, De Meester P, Ducheyne P, Mulier JC, De Langh R, Kestelijn P (1974) Factors in the mechanical failure of femoral component in total hip prosthesis. Acta Orthop Scand 45:693–710
Pazzaglia UE, Ceciliani L, Wilkinson MJ, Dell'Orbo C (1975) Involvement of metal particles in loosening of metal-plastic total hip prostheses. Arch Orthop Trauma Surg 104:164–174
Rostocker W, Chao EYS, Galante JO (1978) Defects in failed stems of hip prostheses. J Biomed Mater Res 12:635–651
Ruju A, Pazzaglia UE, Mora R (1978) Considerazioni sul meccanismo di rottura della stele metallica di una protesi totale d'anca. Minerva Ortopedica 29:297–303
Willert HG, Semlitsch M (1970) Tissue reactions to plastic and metallic wear products of joint endoprostheses total hip prostheses. In: Gschwend N, Debrunner HV (eds) Total hip prosthesis. Huber, Bern
Wroblewski BM (1979) The mechanism of fracture of the femoral prosthesis in total hip replacement. Int Orthop 3:137–139
Wroblewski BM (1982) Fractured stem in total hip replacement. A clinical review of 120 cases. Acta Orthop Scand 53:279–284
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pazzaglia, U.E., Ghisellini, F., Barbieri, D. et al. Failure of the stem in total hip replacement. Arch. Orth. Traum. Surg. 107, 195–202 (1988). https://doi.org/10.1007/BF00449667
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00449667