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The Journal of Bone and Joint Surgery 81:844-7 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Catastrophic Failure of a Cemented, Collarless, Polished, Tapered Cobalt-Chromium Femoral Stem Used with Impaction Bone-Grafting. A Report of Two Cases*

LAITH M. JAZRAWI, M.D.{dagger}, CRAIG J. DELLA VALLE, M.D.{dagger}, FREDERICK J. KUMMER, PH.D.{dagger}, EDWARD M. ADLER, M.D.{dagger} and PAUL E. DI CESARE, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at the Musculoskeletal Research Center, Department of Orthopaedic Surgery, New York University Medical Center-Hospital for Joint Diseases, New York City


   Introduction
 
Revision total hip arthroplasty performed with use of impaction bone-grafting and insertion of a tapered femoral component with cement in patients who have severe bone loss in the proximal part of the femur has yielded encouraging short-term results4,9,10,13,16,17,20. The collarless, polished, tapered (CPT) femoral stem (Zimmer, Warsaw, Indiana), which was designed for this purpose, is manufactured from a high-strength material (forged cobalt-chromium) in order to avoid the substantial rate of stem fracture that has been observed in association with a component of similar geometry, the original Exeter femoral prosthesis (Howmedica, Rutherford, New Jersey)14. Femoral stems made of forged cobalt-chromium-molybdenum alloy rarely fracture; the only such failures of which we are aware were attributed to defects that had been introduced during the manufacturing process18,22. In the original series of 433 polished, stainless-steel Exeter stems, which were implanted between 1970 and 1975, the rate of fracture was 3 percent . . . [Full Text of this Article]


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