Fractures at the tip of long-stem prostheses used for revision hip arthroplasty

J Arthroplasty. 2003 Sep;18(6):741-5. doi: 10.1016/s0883-5403(03)00258-4.


We report a retrospective analysis of the incidence of intraoperative femur fractures at the tip of the prosthesis in 45 consecutive, uncemented, long (205-mm), straight hydroxyapatite, fully coated stems used for revision arthroplasty of the hip. Five patients were lost to follow-up. Intraoperative fractures of the distal femur occurred in 7 cases (17.5%). In the remaining 33 cases in which no fracture occurred, the tip of the implanted stem was found to be potentially at risk for causing a fracture in 18 (55%) cases. We concluded that uncemented, 205-mm, straight femoral stems should be used with caution in the setting of revision hip surgery. A bowed stem of that length may be a safer alternative. Otherwise, a shorter, straight stem may reduce the risk of complications at the stem tip.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coated Materials, Biocompatible
  • Female
  • Femoral Fractures / diagnostic imaging*
  • Femoral Fractures / epidemiology
  • Femoral Fractures / etiology*
  • Hip Prosthesis*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Radiography
  • Reoperation
  • Retrospective Studies


  • Coated Materials, Biocompatible