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

Arthroplasty Today

Marc G.D. Geers, PhD¹  Duncan P. Fransz, MD, MSc, PhD²  René H.M. ten Broeke, MD, PhD³  Marc P.F.H.L. van Maris⁴  Ralph M. Jeuken, MD⁴ 

[1] Corresponding author. P. Debyelaan 25, 6229 HX Maastricht, the Netherlands. Tel.: [phone].;Department of Orthopaedics, Zuyderland Medical Center, Heerlen, Limburg, the Netherlands;Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, Noord-Brabant, the Netherlands;Department of Orthopaedics, Maastricht University Medical Center, Maastricht, Limburg, the Netherlands;

关键词: Case report;    Hip;    Prosthesis;    Failure;    Metallurgy;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

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