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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 6, 742-745.
doi: 10.1302/0301-620X.89B6.18680  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Fracture of the hydroxyapatite-ceramic-coated JRI-Furlong femoral component

BODY MASS INDEX AND IMPLICATIONS FOR SELECTION OF THE IMPLANT

P. Harvie, BEng, MRCS (Eng), Specialist Registrar1; M. Haroon, FRCS, Associate Specialist2; N. Henderson, MA, FRCS, Consultant Trauma and Orthopaedic Surgeon2; and M. El-Guindi, FRCS, Consultant Trauma and Orthopaedic Surgeon2

1 Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
2 Stoke-Mandeville Hospital, Mandeville Road, Aylesbury HP21 8AL, UK.

Correspondence should be sent to Dr P. Harvie; e-mail: harvie1{at}tiscali.co.uk

We describe three cases of fracture of the titanium JRI-Furlong hydroxyapatite-ceramic (HAC)-coated femoral component. We have examined previous case reports of failure of this stem and conclude that fracture may occur in two places, namely at the neck-shoulder junction and at the conical-distal cylindrical junction. These breakages are the result of fatigue in a metallurgically-proven normal femoral component. All the cases of failure of the femoral component have occurred in patients with a body mass index of more than 25 in whom a small component, either size 9 or 10, had been used.

In patients with a body mass index above normal size 9 components should be avoided and the femoral canal should be reamed sufficiently to accept a large femoral component to ensure that there is adequate metaphyseal fixation.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General