Identification of the Cause of the Stem Neck Fracture in the Hip Joint Endoprosthesis

Ryniewicz, Andrzej; Bojko, Łukasz; Pałka, P.; Ryniewicz, Wojciech

doi:10.1515/ijame-2018-0013

Cited by 3 publications

(2 citation statements)

References 23 publications

(19 reference statements)

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“…18 , 25 , 26 , 27 , 28 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 30 cases to the surgeon (i.e., electrocautery contact to the implant, incorrect handling of implant, etc.) 30 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , and 22 cases to the patient (i.e., bone loss, tissue reaction, BMI, trauma) 9 , 17 , 56 – 65 . One hundred and ten cases resulted out of a mixture of the three given causes for failure 13 , 15 , 29 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 .…”

Section: Resultsmentioning

confidence: 99%

Femoral Stem Fracture in Hip Revision Arthroplasty: A Systematic Literature Review of the Real-World Evidence

Sukopp¹,

Taylor

Forst

et al. 2021

Z Orthop Unfall

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Background Total hip arthroplasty (THA) presents as an excellent treatment for the osteoarthritic hip, demonstrating good survival rates. However, aseptic loosening and infection are the main causes of operative revision. The methods used in revision surgery are non-modular or modular THA implants. In addition to the abovementioned revision reasons for THA, this treatment could be associated with the possibility of femoral stem fracture, especially in the modular system. The topic of material failure has been focused on in the public media. The question arises as to how such media reports correlate with the published literature. The observed mentioned number of cases concerning a femoral stem fracture vary between one single case and up to 18.5% within a clinical study, thus presenting an inhomogeneous data situation with a large span. The specific aim of this systematic review is to establish facts and clarify the number of unforeseen events of a femoral stem fracture based on peer review articles and registry data. This clarification is important to us, as these media reports have led to uncertainty among patients. Methods A systematic review was performed in accordance with the PRISMA statement. Peer review articles in English and German, presenting original articles, meta-analyses, or case reports, were searched from the turn of the millennium up to December 2019. Only articles that reported a femoral stem component fracture, with content of clinical data as well as register data, were included. Relevant papers published after the defined research time frame were taken into account within the discussion. Results In total, 218 fractures of a femoral stem (141 primary and 77 revision THA) component could be identified within the selected literature. Most cases of a femoral stem fracture occurred in the modular THA implants compared to the non-modular stems. Regarding revision THA, in summary, 77 implants, presenting 23 non-modular and 54 modular implants, failed by means of femoral stem fracture. A review of 11 National Joint Registries shows a revision rate between 0.04 and 0.05% in only 2 registers according to the specific subject of a femoral stem fracture. For the remaining 9 registers, however, detailed information is lacking and only nonspecific information such as a generic “implant failure” or “other reason” (which can cover a multitude of causes) is supplied. Conclusion A femoral stem fracture presents a devastating complication for the patient, the surgeon as well as for the manufacturer of the implant. Modular THA implants play an increasingly valuable role concerning restoration of individual anatomy in modern THA revision surgery, especially within complex cases. Regarding revision procedures, data suggests a lower risk of femoral stem fracture for modular implants compared to primary procedures, while the risk of fracture for non-modular implants seems to increase during revision. Ultimately, it cannot be proven whether this is actually applicable, since the absolute number of implanted prosthesis systems is not known. Various implant-, patient-, and surgeon-related factors may lead to these reported femoral stem fractures. However, this systematic review suggests that this is, in general, a rare complication.

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Section: Resultsmentioning

confidence: 99%

Femoral Stem Fracture in Hip Revision Arthroplasty: A Systematic Literature Review of the Real-World Evidence

Sukopp¹,

Taylor

Forst

et al. 2021

Z Orthop Unfall

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“…Other applications include the determination of fracture surface morphology, phase distribution and arrangement within the fracture surface. This method can be successfully used for reverse analysis, where the fracture surface morphology helps to deduce not only the cause of the component failure, but also gives answers to the change of the semi-product behavior during the technological process [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Usage of microscopic methods in analysis of non-conforming nickel alloy products

Kuśmierczak

Náprstková

Mičian

2020

19th International Scientific Conference Engineering for Rural Development Proceedings

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The process of creating products with the required utility properties is a multi-stage process determined by a number of factors that determine the resulting quality. Today, given the pressure on the economic side of production, companies have limited input control to the minimum possible. Spectral analysis, material hardness evaluation, or layer thickness control are most often performed. They carry out other analyses in companies sporadically. Common input analyses often do not reveal the actual state of the microstructure such as the presence of undesirable phases, their size, phase distribution, their heterogeneity, etc. These factors affect the weldability and cold formability of the workpiece, and consequently affect the resulting product quality and product life. In the case of bellows production, the input semi-finished products are subject to requirements in terms of technological division of production, which includes input cutting, welding, forming and calibration of the finished product. Even in nickel alloys, the more chemically and structurally complicated the material, the lower its formability. An important factor influencing the formability of these alloys is the occurrence of inclusions. The negative influence of inclusions on cold formability depends on the chemical composition, mechanical properties, their morphology, frequency and distribution in the base matrix. In terms of weldability, nickel alloys are very well weldable. Their weldability is dependent on chemical purity, especially sulphur, carbon and chromium content. The influence of other alloying elements on the weldability of nickel alloys is minimal. Only precipitation-hardened alloys are more difficult to weld. Almost all welding methods as with steel can be used. The paper presents the use of microscopic methods for detecting the causes of non-conforming bellows from nickel alloys.

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Selection methodology of femoral stems under fatigue loading conditions

Galiano

Mejia

Ortiz

et al. 2022

Computer Methods in Biomechanics and Biomedical Engineering

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Identification of the Cause of the Stem Neck Fracture in the Hip Joint Endoprosthesis

Cited by 3 publications

References 23 publications

Femoral Stem Fracture in Hip Revision Arthroplasty: A Systematic Literature Review of the Real-World Evidence

Femoral Stem Fracture in Hip Revision Arthroplasty: A Systematic Literature Review of the Real-World Evidence

Usage of microscopic methods in analysis of non-conforming nickel alloy products

Selection methodology of femoral stems under fatigue loading conditions

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