Hip Replacement Danger: Stem and Neck Fractures

• July 21, 2015
• Hip Replacements

More people are choosing to have a hip replacement to give them back their mobility, improve their ability to perform daily activities, and improve their quality of life.

This surgery involves removing the damaged hip joint and replacing it with a new artificial joint. One popular option is a metal-on-metal (MoM) hip replacement device where a metal femoral head (the ball) and a metal acetabular cup (the socket) replace the natural bone ball-and-socket joint.

Unfortunately, over time, some of these MoM devices are failing due to stem and neck fractures.

What are Stem & Neck Fractures?

The stem, inserted into the femur, anchors the hip implant in place. A stem fracture occurs when this piece breaks in two.

This type of fracture happens most often with modular devices, but can happen with a one-piece design, too. Modularity — where the stem and neck are two pieces — allows surgeons to fit the implant more specifically to the patient; however, it increases the number of mechanical junctions that may lead to fretting, corrosion, and fracture.

Breaking of the stem and neck are serious failures for some of these devices. These fractures typically happen without any warning, requiring emergency surgery to remove and replace the broken device. This can be an extremely invasive, complicated, and expensive procedure with a long and painful recovery.

What Causes Stem & Neck Fractures?

Fractures of this kind are usually the result of fretting wear and corrosion, and happen over time. What may start as a microscopic crack in the modular neck grows until only a small piece of metal holds the neck together.

Fretting wear happens when the parts aren’t completely secure. Tiny, repetitive motions result in wear at the contact surface. Fretting corrosion is the combination of corrosion (such as oxidation, when metal interacts chemically with its surroundings) and fretting wear.

Unfortunately, there aren’t any tests a doctor can perform to find out if the stem or neck is fracturing.

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