Early fracture of the modular neck of a MODULUS femoral stem

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Presentation transcript:

Early fracture of the modular neck of a MODULUS femoral stem Katsufumi Uchiyama, MD, PhD, Takeaki Yamamoto, MD, PhD, Mitsutoshi Moriya, MD, Kensuke Fukushima, MD, Yojiro Minegishi, MD, Naonobu Takahira, MD, PhD, Masashi Takaso, MD, PhD Arthroplasty Today Volume 3, Issue 2, Pages 93-98 (June 2017) DOI: 10.1016/j.artd.2016.09.004 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Radiographic examination of the patient’s left total hip arthroplasty at 3 years and 8 months postoperatively showing a fracture of the modular neck component. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Picture of the broken components after retrieval. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Intraoperative picture of the tapered portion of the proximal stem with evidence of scalloping and pitting. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Immediate postoperative radiographic control image after revision of the broken components. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 5 Pictures of the neck fracture surfaces (left: inferior fragment from the top; right: inferior fragment from the side). We identified the anterior, medial, posterior, and lateral zones of the neck with the letters A, M, P, and L, respectively. The letters I and S denote the inferior and superior parts of the neck fragments, respectively. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 6 Broken screw (right: fracture surface of the superior screw fragment). Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 7 SEM analysis of the fractured surfaces of the neck. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 8 SEM analysis of the fractured surfaces of the screw. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 9 FEA of the involved components showing the stress distribution for a 13-mm neck and a 125° stem at 2400 N. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions

Figure 10 FEA of the involved components showing the stress distribution for a 15-mm neck and a 125° stem at 2600 N. Arthroplasty Today 2017 3, 93-98DOI: (10.1016/j.artd.2016.09.004) Copyright © 2016 The Authors Terms and Conditions