Fractures of Modern High Nitrogen Stainless Steel Cemented Stems

Abstract We present 14 cases of fracture of modern, high-nitrogen, stainless steel stems. Our clinical and radiological data suggest that heavy patients with small stems and poor proximal support are at risk for fracturing their implants. “Champagne-glass” canals can lead to the use of smaller stems...

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Bibliographic Details
Published in:The Journal of arthroplasty 2008-02, Vol.23 (2), p.188-196
Main Authors: Yates, Piers J., MBBS(Hons), BSc(Hons), MRCS FRCS(Tr & Orth), Quraishi, Nasir A., FRCS, Kop, Allan, PhD, MSc, Howie, Donald W., PhD, FRACS, Marx, Clare, FRCS, Swarts, Eric, BSc
Format: Article
Language:English
Subjects:
cement
fracture
high nitrogen
hip arthroplasty
Orthopedics
stainless steel
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Summary:Abstract We present 14 cases of fracture of modern, high-nitrogen, stainless steel stems. Our clinical and radiological data suggest that heavy patients with small stems and poor proximal support are at risk for fracturing their implants. “Champagne-glass” canals can lead to the use of smaller stems often placed in varus, which can lead to cantilever bending and fatigue failure in the distal half of the stem. Metallurgical assessment of the retrieved high-nitrogen, stainless steel stems reveals microstructural inconsistencies that may contribute to their failure. Based on our findings, careful consideration and attention to technique is required when using stainless steel stems in patients with high body mass index or high weight. Technique is particularly important in femurs with champagne-glass canals.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2006.12.051