Fracture of a collared cementless Corail hydroxyapatite-coated femoral stem after primary total hip arthroplasty

Abstract

After a primary or revision total hip arthroplasty, femoral stem fracture remains a very rare complication in Total Hip Arthroplasty (THA).We report a case of a distal-third fracture of a collared titanium (Ti6A14V) femoral stem 23 months after primary total hip arthroplasty (THA). Six months before the Implant fracture, there was suspicion of a proximal stem loosening in the radiological findings. The implants received by the Patient were the latest generation of the Corail Total Hip System from DePuy Synthes (Warsaw, Indiana, USA), which includes the combination of an AltrX neutral polyethylene lining, a Gription-coated Pinnacle 100 cup, a Biolox ceramic head and a collared cementless Corail AMT (Articul/EZE Mini Taper) stem.The proximal portion of the femoral stem did not show features of good osteointegration, such as denuded regions of hydroxyapatite coating and bone tissue adhesion to the material surface, according to the metallurgical investigation, although the distal portion did.In this case, the lack of a proximal buttress was believed to have caused the typical fatigue fracture.

Keywords

• Primary total hip arthroplasty
• THA
• Femoral stem fracture
• Implant loosening
• Osteointegration
• Hip