Intra-operative periprosthetic fracture - total hip arthroplasty

Case contributed by Henry Knipe


Routine follow-up post total hip arthroplasty.

Patient Data

Age: 65 years
Gender: Male

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. 

Linear lucency underneath the medial femoral plate at the femoral calcar.

Resorption/demineralization at the femoral calcar.

Case Discussion

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. 

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