Fracture of an Exeter stem-a case report

摘要

The Exeter femoral stem is a collarless, polished, tapered stem with an excellent track record. It is designed to subside into the cement mantle by creep and plastic deformation of the cement thereby tightening its fit. We present the case of a 121 kilogram 68 year old male patient who had previously undergone bilateral cemented total hip arthroplasty using the Exeter system (Howmedica, Stryker) for underlying osteoarthritis of the hips. He presented 9 years after surgery with catastrophic failure of the left femoral stem, following a mechanical fall from a standing height. We believe this unusual case of stem fracture has not been previously documented in the English literature with the current design of stem. Case Report A 68 year old gentleman who weighed 121 kilograms, and who had previously undergone bilateral cemented Exeter total hip arthroplasty, presented to the emergency department at our hospital following a simple mechanical fall from a standing height. On presentation he complained of pain in his left groin and proximal thigh and had a short and externally rotated left lower limb. Plain radiographs of the pelvis revealed a fracture of the left Exeter femoral prosthesis at the neck-shaft junction. The cement mantle in the femur and acetabular component appeared to be intact (Figures 1 & 2). The patient subsequently underwent revision surgery.