Use of an Interlocking Hydroxyapatite-Coated Stem in a Patient with an Infected Nonunion of a Periprosthetic Femoral Fracture with Massive Bone Loss.

A fifty-nine-year-old woman with seropositive rheumatoid arthritis and osteoporosis underwent an elective total hip replacement with use of a cemented Muller prosthesis. Aseptic loosening of the stem occurred three years later, at which time the patient underwent revision of the stem with a long-stem cemented implant. Seven years later, the patient sustained an atraumatic unstable periprosthetic fracture of the shaft of the femur at the distal end of the prosthesis. In this article authors describes an alternative management option for this complex femoral reconstruction that includes the use of a long-stemmed hydroxyapatite-coated implant with distal interlocking screw fixation.