Total hip stem failure due to weld procedure and material selection misuse

Total hip arthroplasty has been one of the most successful techniques in orthopedics providing good results for long term. The rate of fatigue failure of total hip arthroplasty stem today is very low due to improvements of the technique along many decades. However, any rare case of stem fracture should be treated carefully due to the problems that can result in the revision for the patient. This paper presents failure analysis of three cemented hip stem which experienced fatigue with less than 5 years in use. The failure is associated to design concept which includes a weld procedure at the proximal third of the stem to attach a metallic wire mesh aiming to improve the bonding to the cement mantle. The failure also is associated with the misuse of AISI 316 L as implant material.