Early fatigue failures of cemented, forged, cobalt-chromium femoral stems at the neck-shoulder junction

Femoral component fracture is a rare bur well-documented complication after total hip arthroplasty, Historically, most stem fractures have occurred at the middle third of the implant, where proximal stem loosening and solid d istal stem fixation result in cantilever bending and eventual fatigue failu re. In contrast, we report 2 early fatigue failures of well-positioned, wel l-fixed, cemented, forged, cobalt-chromium femoral components at the neck-s houlder junction. A contributing factor to the implant failures was heavy l aser etching in a region of the implant subjected to high stresses, leading to decreased fatigue resistance and subsequent fracture.