Electrosurgery Induced Femoral Stem Fracture in Total Hip Arthroplasty: A Case Report.

We present a case of a broken titanium alloy (Ti-6Al-7Nb) femoral stem 4 years after revision total hip arthroplasty (THA) (head exchange M to XL for instability). Material analysis showed a superficial anomaly on the superior neck surface caused by local melting with an electrosurgical knife. This lesion presumably acted as a stress riser and was the initiation site of a fatigue fracture, with typical features on the fracture surface. The use of electrosurgical knives in stem retaining THA revision surgery should be avoided, especially for surgical dissection in close proximity to the femoral stem.