{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:08:15Z","timestamp":1777676895774,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"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":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Cemented polished tapered stems have demonstrated excellent long-term outcomes. Based on this concept, many generic tapered stems have been released into the market. The aim of this study was to evaluate implant-related complications of 1 specific stem design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 2010 and 2017, 315 total hip replacements were performed using a Fortress stem (Biotechni, La Ciotat, France). Patient records and radiology were retrospectively reviewed for implant-related complications. A failure analysis was performed on the failed Fortress stems in order to determine the cause of premature failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      7 (2.2%) patients sustained a fracture of the neck of the implant after a mean of 5\u2009years (range 50\u201381\u2009months). All fractures were atraumatic, originating at the introducer inlet of the stem. All fractured occurred in obese patients (BMI &gt;33\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) with a small sized prosthesis. Of these, there were 5 135\u00b0 and 2 125\u00b0 stems. Fracture risk was 23% (7\/30) for patients with a small sized stem and a BMI &gt;30\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . All cases were revised using a cement-in-cement technique or a cementless modular revision stem. Failure analysis on the retrieved stems revealed a stress riser at the bottom of the introducer inlet.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>An alarmingly high rate of early implant fractures was seen using this specific type of cemented stem, particularly when using smaller implant sizes in obese patients. Although based on a proven design, a specific modification led to a stress riser in the neck area, which resulted in a high incidence of implant failure. This series underlines the importance of a stepwise introduction into the market of new orthopaedic devices even when based on established concepts. Generic stems may not behave as the original stem upon which it was designed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120700020925739","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T13:45:27Z","timestamp":1590587127000},"page":"99-105","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["High rates of implant fracture of a generic polished tapered femoral stem"],"prefix":"10.1177","volume":"32","author":[{"given":"Jens","family":"Vanbiervliet","sequence":"first","affiliation":[{"name":"Orthopaedic Department, University Hospital Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annabel","family":"Braem","sequence":"additional","affiliation":[{"name":"Department of Materials Engineering, Catholic University Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Simon","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, University Hospital Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Van Humbeek","sequence":"additional","affiliation":[{"name":"Department of Materials Engineering, Catholic University Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Brouwers","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, University Hospital Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stijn","family":"Ghijselings","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, University Hospital Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"bibr1-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.75B2.8444947"},{"key":"bibr2-1120700020925739","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/BF00266883","volume":"3","author":"Wroblewski BM","year":"1979","journal-title":"Int Orthop"},{"key":"bibr3-1120700020925739","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199712000-00010"},{"key":"bibr4-1120700020925739","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198264090-00012"},{"key":"bibr5-1120700020925739","first-page":"477","volume":"19","author":"Fowler JL","year":"1988","journal-title":"Orthop Clin North Am"},{"key":"bibr6-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B5.1527122"},{"key":"bibr7-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197509000-00014"},{"key":"bibr8-1120700020925739","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199401000-00014"},{"key":"bibr9-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1080\/17453670710014707"},{"key":"bibr10-1120700020925739","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.M.00117"},{"key":"bibr11-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.12.051"},{"key":"bibr12-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B3.0840324"},{"key":"bibr13-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B2.38045"},{"key":"bibr14-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B11.37668"},{"key":"bibr15-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4160-8"},{"key":"bibr16-1120700020925739","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B3.1587883"},{"key":"bibr17-1120700020925739","volume-title":"Implants for surgery - 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