Fractures of modern high nitrogen stainless steel cemented stems: cause, mechanism, and avoidance in 14 cases.
case_series · Level IV
Where this comes from
- Record sourced from PubMed, PMID 18280411.
- Also identified by DOI 10.1016/j.arth.2006.12.051.
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Abstract
We present 14 cases of fracture of modern, high-nitrogen, stainless steel stems. Our clinical and radiological data suggest that heavy patients with small stems and poor proximal support are at risk for fracturing their implants. "Champagne-glass" canals can lead to the use of smaller stems often placed in varus, which can lead to cantilever bending and fatigue failure in the distal half of the stem. Metallurgical assessment of the retrieved high-nitrogen, stainless steel stems reveals microstructural inconsistencies that may contribute to their failure. Based on our findings, careful consideration and attention to technique is required when using stainless steel stems in patients with high body mass index or high weight. Technique is particularly important in femurs with champagne-glass canals.
Medical subject headings
- Arthroplasty, Replacement, Hip
- Hip Prosthesis
- Prosthesis Failure
Anatomy
- femur
- hip