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Femoral stress fractures following revision total hip arthroplasty developed about a cortical window in two patients. These cases differ from previously reported fractures in that there was no significant trauma, the pain was gradual in onset, and there was no displacement at the fracture site. Tomograms and radionuclide bone scans were necessary to reveal the fracture. One femur healed with hip spica immobilization, while the other required bone grafting. Femoral stress fractures should be considered in the differential diagnosis of patients with thigh pain after revision total hip arthroplasty, particularly if a cortical window had been necessary.
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Lotke et al. (1986) studied this question.
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