Implant Fracture after Long-Stemmed Cemented Hemiarthroplasty for Oncologic Indications

Aditya V. Maheshwari; Corey  Gilbert; Jenna  Noveau; Robert Pivec; Robert M.  Henshaw

doi:10.1615/JLongTermEffMedImplants.2014010812

Journal of Long-Term Effects of Medical Implants

Éditeur en chef: Subrata Saha (open in a new tab)

Publication de 4 numéros par an

ISSN Imprimer: 1050-6934

ISSN En ligne: 1940-4379

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Implant Fracture after Long-Stemmed Cemented Hemiarthroplasty for Oncologic Indications

Volume 25, Numéro 3, 2015, pp. 171-178

DOI: 10.1615/JLongTermEffMedImplants.2014010812

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Aditya V. Maheshwari
Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA

Corey Gilbert
Department of Orthopedic Oncology, Washington Hospital Center, 110 Irving Street, Washington DC 20010; Department of Orthopaedics, Howard University Hospital, 2041 Georgia Avenue, Washington DC 20060

Jenna Noveau
Department of Orthopedic Oncology, Washington Hospital Center, 110 Irving Street, Washington DC 20010

Robert Pivec
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY

Robert M. Henshaw
Orthopaedic Oncology, Washington Cancer Institute, Georgetown University School of Medicine, Washington, DC

RÉSUMÉ

Although a long-stemmed cemented hemiarthroplasty is frequently recommended for oncologic lesions of proximal femur, we have observed an alarming number of spontaneous stem fractures. The purpose of this retrospective study was to identify the associated risk factors for stem fractures in a study cohort of 60 (61 prostheses) during 1983−2007. At a mean follow-up of 41 months, 4/61 (6.6%) stems had fractured after a mean of 36 (12−92) months after surgery. All failed implants were Osteonics Omnifit (4/27; 14.8%) and multivariate analysis did not show any correlation with other studied variables. While the failures were successfully salvaged by conversion to a modular proximal femoral replacement, any implant failure in this population is devastating. Spontaneous onset of thigh pain in patients with long stems, particularly if associated with other risk factors, should raise suspicion of a fatigue fracture of the stem.

MOTS CLÉS: long-stemmed cemented, hemiarthroplasty, fatigue fracture, implant fai

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