Prosthetic Fracture of a Cemented Exeter Femoral Stem (Case Report)

We present a single case of fracture of an Exeter femoral prosthesis at the neck, occurring after a fall from standing height, in a lean 70yr lady at 6 years post implantation. The fracture propagated from the insertion dimple on the superior aspect of the prosthesis shoulder. Materials analysis suggested variance in composition of the alloy, particularly with grain size heterogeneity. Whilst Exeter femoral prosthesis fracture is extremely rare, when it does occur the literature suggests it is often in the context of excessive mechanical stresses (obesity, high offset, falls). However, this case may represent a failure of materials rather than mechanical stresses alone.