Fracture of Cementless Femoral Stems at the Mid-Stem Junction in Modular Revision Hip Arthroplasty Systems

We concluded that the stem failure was initiated by a fretting fatigue mechanism and was propagated by a pure bending fatigue mechanism. Risk factors for fractures of the modular junction include excessive body weight and inadequate proximal osseous support because of trochanteric osteotomy, reduced preoperative bone stock, osteolysis, loosening, and/or implant undersizing. Surgeons should consider the use of implants with strengthened junctions when using modular stems in such patients.