Bilateral neck fracture in bimodular femoral stem after primary total hip arthroplasty: a case report

BMC Musculoskeletal Disorders

Zmago Krajnc¹  Jan Zajc¹  Samo K. Fokter¹  Jožef Predan²  Nenad Gubeljak²  Jure Sevšek³ 

[1] Department of Orthopaedic Surgery, University Medical Centre;Faculty of Mechanical Engineering, University of Maribor;Slovenj Gradec General Hospital;

关键词: Bi-modular femoral stem;    Case report;    Modular femoral neck;    Neck fracture;    Taper corrosion;    Titanium alloy;   

DOI  :  10.1186/s12891-021-04210-y

来源: DOAJ

【 摘 要 】

Abstract Background Bi-modular stems were introduced in primary total hip arthroplasty (THA) to enable better control of the femoral offset, leg length, and hip stability. Despite numerous reports on modular femoral neck fractures, some designs are still marketed worldwide. While the risk factors for the sudden failure are multifactorial and mostly known, the timing of this new THA complication is not predictable by any means. Case presentation In this report, the literature regarding one of the most popular bi-modular stems with specific neck-stem coupling (oval Morse taper) is reviewed and illustrated with a case of bilateral modular neck fracture in a patient with idiopathic aseptic necrosis of femoral heads treated with primary bi-modular THA. Because of bilateral modular femoral neck fracture, which occurred 3 years on the left side and 20 years after implantation on the right side, the patient required a total of 6 revisions and 208 days of hospitalized care. Conclusion To our knowledge, this is the first report of bilateral modular neck fracture in a single patient. Even though the same surgeon performed both operations and used the same neck length and orientation, fractures occurred with a 17-year time difference after implantation. This shows that we cannot predict with certainty when a fracture might occur. Orthopaedic surgeons should use bi-modular stem designs for primary THA very cautiously.

【 授权许可】

Unknown