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Case report
History, treatment and analysis of a rare form of Exeter stem fracture
  1. Darren Patrick Moloney1,2,
  2. Robert J Hurley2,
  3. James Harty2 and
  4. Shane Guerin2
  1. 1Colorectal Surgery, Tallaght Hospital, Dublin, Ireland
  2. 2Orthopaedics, Cork University Hospital Group, Cork, Munster, Ireland
  1. Correspondence to Darren Patrick Moloney; 111332391{at}


The Exeter stem by Stryker has become one of the most successful and widely used stems in modern cemented hip arthroplasty. We present a case of a rare stem fracture which was treated by ‘cement-in-cement’ revision arthroplasty technique. The patient, an 87-year-old man, presented with left hip pain and an inability to weight bear following a cracking sensation when he was standing to dress himself. The patient denied history of fall or trauma. On examination he was noted to have a shortened externally rotated left lower limb without neurovascular compromise. On pelvic radiograph he was noted to have an incomplete stem fracture of his left-sided total hip replacement. He was treated with a cement-in-cement revision. Postoperatively the stem was sent for analysis in the London Implant Retrieval Centre. This is an example of a rare form of stem fatigue failure treated with a well-described technique in revision arthroplasty.

  • hip implants
  • prosthesis failure
  • hip prosthesis implantation

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  • Contributors DPM and RJH were involved in patient care and assisted in the revision surgery described. DPM wrote the case report. RJH provided extensive research into Exeter stem fractures and took part in proofreading the case report. JH was the surgeon who performed the patient’s revision surgery. His extensive experience in revision arthroplasty was key to patient care and guidance was integral to the research. SG noted that this was a rare occurrence and worth documenting. SG proofread the case report and was integral in contacting the London Implant Retrieval Centre to analyse this stem fracture.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.