Case report: revision surgery for a fractured femoral stem using an ESOP prosthesis – analysis of the diagnostic work-up, treatment strategy, and long-term outcome

Abstract

Femoral stem fracture following total hip arthroplasty is a rare but serious complication that usually requires removal of both implant fragments and implantation of a longer revision stem. However, this procedure may be associated with substantial bone loss and an increased risk of intraoperative and postoperative complications. A 58-year-old man underwent cementless total hip arthroplasty with a Zweymüller-type stem in 2008. Five years later, the stem fractured. During revision surgery, the proximal fragment was removed, whereas the well-fixed distal fragment could not be safely extracted. It was therefore retained, and only the proximal component of a modular ESOP (anatomical modular cementless femoral stem) short stem was implanted. The postoperative course was uneventful. At 13-year follow-up, the patient remains pain-free, with full hip function, and no radiographic evidence of implant loosening. In carefully selected cases, this technique may represent a valuable alternative to extensive revision surgery.