Atypical Subtrochanteric Femur Fracture and Hip Osteoarthritis Treated with a Revision Monoblock Stem and Strut Allograft: A Case Report

JBJS Case Connect. Jul-Sep 2020;10(3):e2000038. doi: 10.2106/JBJS.CC.20.00038.

Abstract

Case: A 73-year-old woman was diagnosed with a nondisplaced incomplete atypical bisphosphonate-related subtrochanteric femur fracture and ipsilateral hip osteoarthritis. She was treated with a total hip arthroplasty using a monoblock revision stem and a strut allograft to provide adjunctive mechanical and biological support. At the final follow-up, the patient had no pain, the stem was well fixed, and the allograft strut had incorporated; however, a persistent fracture line was noted.

Conclusion: When an atypical femur fracture coexists with hip osteoarthritis, total hip arthroplasty may be a reasonable treatment option to address the fracture and concomitant hip osteoarthritis with a single surgical intervention. However, consideration should be given to using a stem with distal fixation and augmenting the construct with a strut allograft.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Allografts
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Transplantation / methods*
  • Diphosphonates / adverse effects
  • Female
  • Femoral Fractures / chemically induced
  • Femoral Fractures / surgery*
  • Hip Prosthesis*
  • Humans
  • Osteoarthritis, Hip / complications*

Substances

  • Diphosphonates