Intra-operative periprosthetic fracture - total hip arthroplasty
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At the time the case was submitted for publication Henry Knipe had the following disclosures:
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Routine follow-up post total hip arthroplasty.
Left total hip replacement. No periprosthetic lucency or hardware failure. Soft tissue gas and staples.
Zoomed and heavily windowed image shows a small lucency at the femoral calcar.
6 weeks post-op
Linear lucency underneath the medial femoral plate at the femoral calcar.
10 months post-op
Resorption/demineralization at the femoral calcar.
Intra-operative periprosthetic fractures are uncommon. The femoral calcar resorption on the 10 month post-operative radiograph could easily be interpreted as stress shielding but the 6 week post-operative radiograph clearly shows a small periprosthetic fracture. The fracture was not seen on the immediate post-operative radiograph, and only with zoom and heavy windowing can it be easily appreciated.