Fig. 1

Zone of interest of the anteroposterior pelvic radiographs of three different patients presenting with a well-integrated, broken, uncemented stem after hip arthroplasty. All cases have in common that no standard extraction component can be fitted anymore. In a, a 76-year-old male patient presenting less than 4 years after stem-preserving revision with exchange of the head, performed due to instability, with a well-fixed uncemented primary stem (AMIStem-H, Medacta, Castel San Pietro, Switzerland) broken at the neck. Analysis of the retrievals confirmed electrocautery damage as the cause of the fatigue fracture. In b, a 72-year-old male patient presenting 6 years after stem exchange performed due to a periprosthetic fracture through a transfemoral approach, with reconstruction performed with a tapered, fluted, modular, straight 200-mm stem with distal anchoring (Revitan straight, Zimmer Biomet, Winterthur, Switzerland). Failure was at the level of the connection pin, which had milled out from the bore within the distal component of the stem. In c, a 73-year-old male patient presenting with recurrent failure of the modular connection of a stem implanted 15 years earlier through a transfemoral approach. The proximal component is obviously angulated and loosened again. Reconstruction had been performed with a tapered, fluted, modular, straight 200-mm stem with distal anchoring (PFM-R, Zimmer Biomet, Winterthur, Switzerland) due to aseptic loosening of a previously implanted cemented stem. Nine years later, another revision with exchange of the proximal component due to loosening of the modular connection had been performed