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Revision of a fractured uncemented revision stem using a custom designed punch and retrograde through-knee approach.

Nasr PJ, Keene GS - Case Rep Orthop (2015)

Bottom Line: We report a unique case of a fractured modular cobalt chromium connection taper Revitan (Zimmer, Warsaw, IN) revision prosthesis.Macroscopic examination revealed a fracture at the diaphyseal-metaphyseal junction of this modular component.We also describe a unique method of retrieval for a broken well fixed uncemented femoral stem, using a custom designed extraction instrument via a through-knee approach.

View Article: PubMed Central - PubMed

Affiliation: Addenbrooke's Hospital, Cambridge Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.

ABSTRACT
We report a unique case of a fractured modular cobalt chromium connection taper Revitan (Zimmer, Warsaw, IN) revision prosthesis. Macroscopic examination revealed a fracture at the diaphyseal-metaphyseal junction of this modular component. This report highlights that fractures can still occur with modern modular prostheses. We are not aware of any published failures of the Revitan revision prosthesis. We also describe a unique method of retrieval for a broken well fixed uncemented femoral stem, using a custom designed extraction instrument via a through-knee approach.

No MeSH data available.


Related in: MedlinePlus

Intraoperative Image Intensifier image of femoral diaphysis after removal of Revitan femoral component, showing no evidence of fracture or loss of bone stock.
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fig3: Intraoperative Image Intensifier image of femoral diaphysis after removal of Revitan femoral component, showing no evidence of fracture or loss of bone stock.

Mentions: A posterior approach was used to the hip. The stem could not be retrieved from the area around the greater trochanter. Attention was then made to retrieval of the well fixed diaphyseal portion of the broken stem. A midline incision was made over the knee and a medial parapatellar approach performed. A 16 mm drill was used to gain entry to the distal femoral metaphysis and our custom made instrument inserted retrograde to punch the well fixed femoral component towards the proximal femur. Image intensifier guidance was used throughout the procedure (Figure 2). The stem was disengaged and then retrieved with ease, without any fracture occurring or loss of the femoral bone stock (Figure 3).


Revision of a fractured uncemented revision stem using a custom designed punch and retrograde through-knee approach.

Nasr PJ, Keene GS - Case Rep Orthop (2015)

Intraoperative Image Intensifier image of femoral diaphysis after removal of Revitan femoral component, showing no evidence of fracture or loss of bone stock.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4352446&req=5

fig3: Intraoperative Image Intensifier image of femoral diaphysis after removal of Revitan femoral component, showing no evidence of fracture or loss of bone stock.
Mentions: A posterior approach was used to the hip. The stem could not be retrieved from the area around the greater trochanter. Attention was then made to retrieval of the well fixed diaphyseal portion of the broken stem. A midline incision was made over the knee and a medial parapatellar approach performed. A 16 mm drill was used to gain entry to the distal femoral metaphysis and our custom made instrument inserted retrograde to punch the well fixed femoral component towards the proximal femur. Image intensifier guidance was used throughout the procedure (Figure 2). The stem was disengaged and then retrieved with ease, without any fracture occurring or loss of the femoral bone stock (Figure 3).

Bottom Line: We report a unique case of a fractured modular cobalt chromium connection taper Revitan (Zimmer, Warsaw, IN) revision prosthesis.Macroscopic examination revealed a fracture at the diaphyseal-metaphyseal junction of this modular component.We also describe a unique method of retrieval for a broken well fixed uncemented femoral stem, using a custom designed extraction instrument via a through-knee approach.

View Article: PubMed Central - PubMed

Affiliation: Addenbrooke's Hospital, Cambridge Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.

ABSTRACT
We report a unique case of a fractured modular cobalt chromium connection taper Revitan (Zimmer, Warsaw, IN) revision prosthesis. Macroscopic examination revealed a fracture at the diaphyseal-metaphyseal junction of this modular component. This report highlights that fractures can still occur with modern modular prostheses. We are not aware of any published failures of the Revitan revision prosthesis. We also describe a unique method of retrieval for a broken well fixed uncemented femoral stem, using a custom designed extraction instrument via a through-knee approach.

No MeSH data available.


Related in: MedlinePlus