Case: We present a case of a broken titanium alloy (Ti-6Al-7Nb) femoral stem 4 years after revision total hip arthroplasty (THA) (head exchange M to XL for instability). Material analysis showed a superficial anomaly on the superior neck surface caused by local melting with an electrosurgical knife. This lesion presumably acted as a stress riser and was the initiation site of a fatigue fracture, with typical features on the fracture surface.
Conclusions: The use of electrosurgical knives in stem retaining THA revision surgery should be avoided, especially for surgical dissection in close proximity to the femoral stem.