Nonsurgical Management of Distal Femur Stem Cortical Perforation

Minzhi Yang; Jerry Yongqiang Chen; Xiangpeng Kong; Wei Chai

doi:10.1016/j.artd.2020.03.002

Nonsurgical Management of Distal Femur Stem Cortical Perforation

Arthroplast Today. 2020 Apr 23;6(2):153-157. doi: 10.1016/j.artd.2020.03.002. eCollection 2020 Jun.

Authors

Minzhi Yang^{1

2}, Jerry Yongqiang Chen³, Xiangpeng Kong¹, Wei Chai¹

Affiliations

¹ Department of Joint Surgery, Chinese PLA General Hospital, Haidian, Beijing, China.
² Medical School, Nankai University, Nankai, Tianjin, China.
³ Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Abstract

Distal femur stem cortical perforation is a rare but potentially catastrophic complication during total hip arthroplasty. If unrecognized, it can lead to transverse fracture of the femur while the patient is ambulating. If an uncemented femur stem was used, previous literature unanimously agrees that revision surgery should be performed. We report a case of uncemented distal femur stem cortical perforation that was treated nonsurgically successfully with protected weight-bearing for 6 weeks. Our patient had previous osteotomy surgeries of the proximal femur with a residual deformity which increased her risk for distal femur stem cortical perforation. At 40-month follow-up, she was asymptomatic, ambulated with normal gait, and was able to perform deep squats. The discussion involves avoiding, recognizing, and managing distal femur stem cortical perforation.

Keywords: Complication; Distal femur stem cortical perforation; Uncemented femur stem; total hip arthroplasty.

Publication types

Case Reports