Fracture of a Titanium Non-Modular Femoral Stem After Revision Total Hip Arthroplasty: A Case Report and Review of the Literature

Background: Femoral stem fracture is a rare and morbid complication after total hip arthroplasty (THA). There currently exists a paucity of reports regarding cementless non-modular, titanium, femoral stem fractures. Methods: A case report and review of the literature for modular and non-modular stem fractures was conducted. Results: We report the first documented fatigue fracture in the Wagner Self-Locking (SL) Revision (Zimmer-Biomet, Warsaw, Indiana) System. Discussion: Proximal stress shielding can lead to poor bone support and contribute to excessive cantilever bending forces, even on non-modular, titanium, tapered stems. Body mass index, prosthetic diameter, and stem length are factors that need to be vetted in order to prevent this complication.