{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:12:04Z","timestamp":1787019124358,"version":"build-2736575974"},"reference-count":46,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T00:00:00Z","timestamp":1554336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Breakage of the femoral stem component of a total hip replacement is now uncommon but continues to be seen with certain stem designs and in certain patient groups. Data previously published on this topic has been limited, either gathered from a single surgeon or centre, or included only a single stem design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed the data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), identified and analysed 143 stem breakages over a period of 16 years, covering 44 different stem designs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Our data confirms previously published findings that risk factors for stem breakage include patient age at implantation of under 70, male gender, as well as the use of exchangeable necks. We found no association with initial diagnosis, or type of acetabular component implanted. We did however also find, excluding exchangeable neck designs, that after 4.5 years a cemented stem had a significantly higher risk of breakage then a cementless stem.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>To our knowledge this is the 1st paper to suggest cemented fixation as a specific risk factor for stem breakage. The analysis of rare complications such as stem breakage is only possible through large data collection systems such as the AOANJRR. Whilst there have been recent advances in materials and manufacturing techniques, we recommend that surgeons are aware of all the specific risks when considering implant choices for individual patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120700019839206","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T06:32:45Z","timestamp":1554359565000},"page":"319-326","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors for femoral stem breakage: an analysis of the AOANJRR results"],"prefix":"10.1177","volume":"30","author":[{"given":"Mark S","family":"Rickman","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"Discipline of Orthopaedics and Trauma, University of Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter L","family":"Lewis","sequence":"additional","affiliation":[{"name":"Wakefield Orthopaedic Clinic, Adelaide, Australia"},{"name":"AOA (Australian Orthopaedic Association) National Joint Replacement Registry, SAHMRI (South Australia Health and Research Institute), Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daud TS","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"Discipline of Orthopaedics and Trauma, University of Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Brisbane Orthopaedic Specialist Services, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E","family":"Graves","sequence":"additional","affiliation":[{"name":"AOA (Australian Orthopaedic Association) National Joint Replacement Registry, SAHMRI (South Australia Health and Research Institute), Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lorimer","sequence":"additional","affiliation":[{"name":"AOA (Australian Orthopaedic Association) National Joint Replacement Registry, SAHMRI (South Australia Health and Research Institute), Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"bibr1-1120700019839206","doi-asserted-by":"crossref","first-page":"670","DOI":"10.2106\/00004623-198062040-00026","volume":"62","author":"Galante JO.","year":"1980","journal-title":"J Bone Joint Surg Am"},{"key":"bibr2-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01107"},{"key":"bibr3-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2009.07.015"},{"key":"bibr4-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4542-0"},{"key":"bibr5-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-3"},{"key":"bibr6-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01033"},{"key":"bibr7-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2010","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2010"},{"key":"bibr8-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2011","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2011"},{"key":"bibr9-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2012","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2012"},{"key":"bibr10-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2013","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2013"},{"key":"bibr11-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2015","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2015"},{"key":"bibr12-1120700019839206","volume-title":"Hip and Knee Arthroplasty Annual Report 2014","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2014"},{"key":"bibr13-1120700019839206","volume-title":"Hip, Knee and Shoulder Arthroplasty Annual Report 2016","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2016"},{"key":"bibr14-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199712000-00010"},{"key":"bibr15-1120700019839206","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/00003086-197509000-00014","author":"Charnley J.","year":"1975","journal-title":"Clin Orthop Relat Res"},{"key":"bibr16-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197658050-00006"},{"key":"bibr17-1120700019839206","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.kjms.2011.11.018","volume":"28","author":"Lu HC","year":"2012","journal-title":"Kaohsiung J Med Sci"},{"key":"bibr18-1120700019839206","first-page":"146","author":"Sotereanos NG","year":"1995","journal-title":"Clin Orthop Relat Res"},{"key":"bibr19-1120700019839206","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00003086-200403000-00024","author":"Crowninshield RD","year":"2004","journal-title":"Clin Orthop Relat Res"},{"key":"bibr20-1120700019839206","first-page":"46","volume":"72","author":"M\u00fcller ME.","year":"1970","journal-title":"Clin Orthop Relat Res"},{"key":"bibr21-1120700019839206","doi-asserted-by":"crossref","first-page":"230","DOI":"10.2106\/00004623-197557020-00017","volume":"57","author":"Galante JO","year":"1975","journal-title":"J Bone Joint Surg Am"},{"key":"bibr22-1120700019839206","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2015.1112188"},{"key":"bibr23-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.M.00117"},{"key":"bibr24-1120700019839206","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.bj.2018.02.001","volume":"41","author":"Chang CH","year":"2018","journal-title":"Biomed J"},{"key":"bibr25-1120700019839206","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s00264-013-2110-3","volume":"38","author":"Sadoghi P","year":"2014","journal-title":"Int Orthop"},{"key":"bibr26-1120700019839206","first-page":"206","volume":"67","author":"Gie GA","year":"1996","journal-title":"Acta Orthop Scand"},{"key":"bibr27-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1177\/112070001002000202"},{"key":"bibr28-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.05.020"},{"key":"bibr29-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2013.02.010"},{"key":"bibr30-1120700019839206","volume":"2012","author":"Morley D","year":"2012","journal-title":"Case Rep Ortho"},{"key":"bibr31-1120700019839206","volume":"2016","author":"Al-Azzani WA","year":"2016","journal-title":"J Surg Case Rep"},{"key":"bibr32-1120700019839206","doi-asserted-by":"crossref","DOI":"10.1308\/003588413X13629960047993","volume":"95","author":"Davies BM","year":"2013","journal-title":"Ann R Coll Surg Engl"},{"key":"bibr33-1120700019839206","first-page":"202","author":"Sumner DR","year":"1992","journal-title":"Clin Orthop Relat Res"},{"key":"bibr34-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-3182-5"},{"key":"bibr35-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2010.07.003"},{"key":"bibr36-1120700019839206","doi-asserted-by":"crossref","first-page":"573","DOI":"10.2106\/00004623-200204000-00010","volume":"84","author":"Harrington MA","year":"2002","journal-title":"J Bone Joint Surg Am"},{"key":"bibr37-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.02.083"},{"key":"bibr38-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(93)90146-2"},{"key":"bibr39-1120700019839206","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197759080-00006"},{"key":"bibr40-1120700019839206","doi-asserted-by":"publisher","DOI":"10.3109\/17453678208992216"},{"key":"bibr41-1120700019839206","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1308\/rcsann.2016.0103","volume":"98","author":"Craik JD","year":"2016","journal-title":"Ann R Coll Surg Engl"},{"key":"bibr42-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2001.20542"},{"key":"bibr43-1120700019839206","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jor.2013.04.007","volume":"10","author":"Jang B","year":"2013","journal-title":"J Orthopaedics"},{"key":"bibr44-1120700019839206","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.otsr.2015.10.009","volume":"102","author":"Merini A","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"key":"bibr45-1120700019839206","doi-asserted-by":"publisher","DOI":"10.5301\/HIP.2011.8652"},{"key":"bibr46-1120700019839206","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B10.16528"}],"container-title":["HIP International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1120700019839206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1120700019839206","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1120700019839206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:21:11Z","timestamp":1777450871000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1120700019839206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,4]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1177\/1120700019839206"],"URL":"https:\/\/doi.org\/10.1177\/1120700019839206","relation":{},"ISSN":["1120-7000","1724-6067"],"issn-type":[{"value":"1120-7000","type":"print"},{"value":"1724-6067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,4]]}}}