Neck fracture of the Exeter stem in 3 patients

A 63-year-old woman (height 1.70 m, weight 92 kg, BMI 31) with developmental dysplasia of both hips underwent bilateral hybrid total hip replacement (THR) using the cemented Exeter V40 stem (offset 44 mm, size 3) and uncemented Trident PSL (Stryker) with alumina-on-alumina ceramic bearing (Biolox Forte; Ceramtec, Plochingen, Baden-Württemberg, Ger- many) at our hospital in 2004. A ceramic femoral head with a diameter of 36 mm and offset of +5 mm was used. Short- term functional outcome was excellent. 5 years and 3 months later, the patient tripped on a flat floor and fell down, and was unable to move her left leg due to severe pain. Plain radio- graphs revealed a neck fracture in the Exeter stem. She under- went revision surgery, during which both the remnant of the Exeter stem and the uncemented acetabular component were found to be well fixed.