Fracture of the femur in revision hip arthroplasty with a fully porous-coated component

Fifty-four consecutive femoral component revisions with uncemented fully porous-coated stems were retrospectively reviewed for the prevalence of intraoperative fracture. Fracture of the femoral diaphysis occurred during insertion of a curved stem in 8 (15%) hips. One additional distal fracture of the femur occurred during exposure of the hip. All fractures occurred with a curved femoral stem. Treatment for intraoperative fractures included open reduction and internal fixation with cortical strut grafts and cables followed by protected weight bearing. This was successful in 6 hips. Even with the use of a curved stem, we report a high prevalence of intraoperative fracture of the femur in revision hip arthroplasty.