A broken, metal (cobalt-chrome) hip implant consisting of an upper femoral head and collar, and a long lower stem. The implant, an Echelon model produced by Smith & Nephew, is fractured and separated around ⅓ of the distance from the femoral head. It is in two pieces.
The head and collar are highly polished. The majority of the stem is covered with a porous titanium surface texture to promote bone ingrowth. Patches of this textured surface have been lost primarily due to wear while implanted, possibly also due to damage during removal. The lower extremity of the stem is uncoated, but is fluted to reduce unwanted movement when implanted. This section has a distal slot meant to reduce the stiffness of the tip, to facilitate insertion and thereby to reduce the risk of fracture.
Accession Number: 2025.med.54
Alternative Name: Artificial Hip.
Cobalt-Chrome, Titanium (sintered portion)
Printed on the upper surface of the stem collar: “C [“R symbol”] 71340413 // SZ 13 L // 01BM06304″
Lower, narrow piece: Length = 19.5, Max diam. = 1.1; Upper piece: Height = 12.5, Width = 2.5, Length = 7.
This is a revision implant, meaning that it is designed to replace an earlier implant that has worn or failed, or to address an infection in the area surrounding the implant. It is an uncemented hip implant, relying on friction for stability, as well as a porous surface to encourage bone ingrowth.
This implant fractured after implant and was removed from a patient.
This artifact is clean but significantly damaged. It is broken into two pieces. Patches of sintered coating are missing, especially near the lower portion of the stem.
Associated Instruments:
Manufacturer: Smith & Nephew. Watford, England.
Date of Manufacture: c. 1990s
These items were among a small collection of artifacts donated by Dr. Allan Gross of Mount Sinai Hospital on 14 April 2025.
Joshua Landa, Michael Benke, Alan Dayan, Gavin Pereira, and Paul E Di Cesare (2009). “Fracture of Fully Coated Echelon Femoral Stems in Revision Total Hip Arthroplasty.” The Journal of Arthroplasty 24, no. 2:: 322.e13-322.e18.
Dror Lakstein, Noam Eliaz, Ofer Levi, David Backstein, Yona Kosashvili, Oleg Safir, and Allan E Gross. “Fracture of Cementless Femoral Stems at the Mid-Stem Junction in Modular Revision Hip Arthroplasty Systems.” Journal of Bone and Joint Surgery. American Volume 93, no. 1 (2011): 57–65.
Revision Total Hip Arthroplasty, the replacement of a worn or failed artificial hip, is typically a more complex and challenging operation than the installation of the initial implant. A subset of orthopedic technology is dedicated to the replacement of existing implants. This is an example.
This is a cementless design, meaning that it does not require bone cement, but relies on friction and bone ingrowth into the sintered, porous surface. Such designs are intended to avoid several complications from the deterioration of cement.
This design has fractured, and was removed from a patient. This example was gathered from, and presumably remove at, the Orthopedic Department, Mount Sinai Hospital, Toronto. This group has published on mid-stem fractures of revision femoral implants, though their study focused on implants manufactured by Zimmer (see Lakstein et al. 2011). The details of this particular example are unknown, but similar failures of these devices have been studied (see Landa et al. 2009). In such cases, the lower portion can be especially difficult to remove as it is implanted deep within the femur and embedded in ingrown tissue.
- Donated to UTSIC