Mechanical insufficiency fractures of modular femoral stems in hip arthroplasty: a case series of three patients
DOI:
https://doi.org/10.64575/pcy5z952Keywords:
Femoral stem fracture, modular femoral stem, implant failure, arthroplasty, total hip arthroplasty, hemiarthroplastyAbstract
Hip arthroplasty (HA) is a widely accepted treatment method for various hip conditions that significantly reduces pain and improves function. Despite advances in surgical techniques, some patients experience complications that may require revision surgery. Modular femoral stems are widely used in HA because of their advantageous features, such as the ability to adjust femoral offset, leg length, and anteversion. However, mechanical failure can occur at the modular junction. Although rare, this is a serious complication. This study presents three patients who had previously undergone HA and subsequently developed failure at the modular femoral stem junction.
References
1. Nair A, Gupta A, Phalak MO, Chopra S. A Case of a Failed Hemiarthroplasty of the Hip Treated by an Extended Trochanteric Osteotomy. Cureus. 2024;16(5):e60948. doi: 10.7759/cureus.60948. DOI: https://doi.org/10.7759/cureus.60948
2. Vasios IS, Makiev KG, Drosos G, Iliopoulos E, Tilkeridis K. Revision of Total Hip Arthroplasties Using Short Femoral Stems: Is It Possible? J Orthop Case Rep. 2025;15(7):43-7. doi: 10.13107/jocr.2025.v15.i07.5762. DOI: https://doi.org/10.13107/jocr.2025.v15.i07.5762
3. Wahl P, Solinger T, Schläppi M, Gautier E. Removal of an osteointegrated broken uncemented femoral stem after hip arthroplasty-technical note. J Orthop Surg Res. 2021;16(1):221. doi: 10.1186/s13018-021-02365-x. DOI: https://doi.org/10.1186/s13018-021-02365-x
4. Lakstein D, Eliaz N, Levi O, Backstein D, Kosashvili Y, Safir O, et al. Fracture of cementless femoral stems at the mid-stem junction in modular revision hip arthroplasty systems. J Bone Joint Surg Am. 2011;93(1):57-65. doi: 10.2106/JBJS.I.01589. DOI: https://doi.org/10.2106/JBJS.I.01589
5. Herold F, Nötzli H, Eijer H. Short proximal components in modular revision stems carry a higher risk for stem fractures. Hip Int. 2021;31(3):398-403. doi: 10.1177/1120700019884049. DOI: https://doi.org/10.1177/1120700019884049
6. Bäcker HC, Wu CH, Kienzle A, Perka C, Gwinner C. Mechanical failure of total hip arthroplasties and associated risk factors. Arch Orthop Trauma Surg. 2023;143(2):1061-9. doi: 10.1007/s00402-022-04353-0. DOI: https://doi.org/10.1007/s00402-022-04353-0
7. Bischel OE, Suda AJ, Böhm PM, Bormann T, Jäger S, Seeger JB. Breakage of Tapered Junctions of Modular Stems in Revision Total Hip Arthroplasty-High Incidence in a Consecutive Series of a Single Institution. Bioengineering (Basel). 2023;10(3):341. doi: 10.3390/bioengineering10030341. DOI: https://doi.org/10.3390/bioengineering10030341
8. Murena L, Maritan G, Concina C, Scamacca V, Ratti C, Canton G. Fracture of Cobalt-Crome Modular Neck in Total Hip Arthroplasty. Acta Biomed. 2019;90(12-S):187-91. doi: 10.23750/abm.v90i12-S.8941.
9. Bicanic G, Crnogaca K, Delimar D. A simple new technique for the removal of fractured femoral stems: a case report. J Med Case Rep. 2014;8:151. doi: 10.1186/1752-1947-8-151. DOI: https://doi.org/10.1186/1752-1947-8-151
10. Krueger DR, Guenther KP, Deml MC, Perka C. Mechanical failure of 113 uncemented modular revision femoral components. Bone Joint J. 2020;102-B(5):573-9. doi: 10.1302/0301-620X.102B5.BJJ-2019-1333.R2. DOI: https://doi.org/10.1302/0301-620X.102B5.BJJ-2019-1333.R2
11. Mertl P, Dehl M. Femoral stem modularity. Orthop Traumatol Surg Res. 2020;106(1S):35-42. doi: 10.1016/j.otsr.2019.05.019. DOI: https://doi.org/10.1016/j.otsr.2019.05.019
12. Fink B. What can the surgeon do to reduce the risk of junction breakage in modular revision stems? Arthroplast Today. 2018;4(3):306-9. doi: 10.1016/j.artd.2018.03.002. DOI: https://doi.org/10.1016/j.artd.2018.03.002
13. Sulje Z, Crnogaca K, Delimar D, Bicanic G. Fracture of revision modular femoral stem. MOJ Orthop Rheumatol. 2016;6(6):00245. doi: 10.15406/mojor.2016.06.00245. DOI: https://doi.org/10.15406/mojor.2016.06.00245
14. Doğan HS, Deniz F, Bozkurt S. Necessity of osteosynthesis in elderly patients with osteoporotic proximal femur fractures. J Multidiscip Orthop Surg. 2025;1(2):48-50. doi: 10.64575/btfwbe13. DOI: https://doi.org/10.64575/btfwbe13
15. Aldowekat O, Al-Ajlouni J, Al-Awad T, Smida M, Ta’ani Z. Failure of a Modular Femoral Revision Stem in Hip Arthroplasty: A Rare Complication and Literature Review. J Orthop Case Rep. 2026;16(4):29-37. doi: 10.13107/jocr.2026.v16.i04.7026. DOI: https://doi.org/10.13107/jocr.2026.v16.i04.7026
16. Arafah MA, Almalki AH, Arafah OM. Management of a broken modular femoral stem following total hip arthroplasty in a patient with sickle cell disease using an endofemoral trephine reamer: A case report. Int J Surg Case Rep. 2021;81:105643. doi: 10.1016/j.ijscr.2021.02.029. DOI: https://doi.org/10.1016/j.ijscr.2021.02.029
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Tarık Özdin, Ali Eray Günay, Atilla Koçer (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC BY-NC) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
Content on this site is licensed under a 