Failure Mode Analysis of an Exeter Stem Fracture Initiated at the Introducer Hole: Time for a Design Change?

The fracturing of a hip prosthesis stem at its neck, in the absence of a trauma, is an extremely rare but serious adverse event. The patient in our case was young, active, and tall, thereby putting high mechanical loads on the prosthesis. Radiographs of the initial procedure and blood and synovium a...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Ralph M. Jeuken, MD, Duncan P. Fransz, MD, MSc, PhD, Marc G.D. Geers, PhD, Marc P.F.H.L. van Maris, René H.M. ten Broeke, MD, PhD
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
Hip
Acceso en línea:https://doaj.org/article/b49ee6d4d6c342f0aba248f6d438d9bc
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
Descripción
Sumario:The fracturing of a hip prosthesis stem at its neck, in the absence of a trauma, is an extremely rare but serious adverse event. The patient in our case was young, active, and tall, thereby putting high mechanical loads on the prosthesis. Radiographs of the initial procedure and blood and synovium analysis showed no abnormalities. Analysis of the stem revealed niobium-rich precipitates, that is, alloy artifacts, at the introducer stud hole. The mechanically vulnerable location of the introducer stud hole, combined with alloy artifacts at that location and high mechanical stress, ultimately led to failure of the prosthesis. As younger and heavier patients will demand hip arthroplasty in the future, simple stem design adaptations should be considered to prevent stem fractures at the introducer stud hole.