Periprosthetic fracture caused by stress shielding after implantation of a femoral condyle endoprosthesis in a transfemoral amputee—a case report

Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. DOI 0.3109/17453674.2010.533937 A femoral condyle endoprosthesis (FCE) was implanted in a 48-year-old transfemorally amputated woman with the intention of making the amputation stump fully endbearing (Figure 1). The implant was a customized endoprosthesis of titanium alloy (Scandinavian Customized Prosthesis AS, Trondheim, Norway), based on experience of the Unique Customized Femoral Stem (Aamodt et al. 1999). Cross-sectional CT images were used to retrieve the inner cortical contours of the femoral diaphysis, and the stem was designed to fit closely within the femoral canal (Aamodt et al. 1999). The stem was fully coated with a dual layer of titanium and hydroxyapatite. During implantation, a small fissure occurred at the anterior aspect of the distal part of the femur, which was secured with 2 cerclage wires. There were no other peroperative or postoperative complications. After 6 weeks of unloading, the patient received a new artificial limb with a prosthetic socket that allowed endbearing. At the 12-month follow-up, the patient was using a knee disarticulation socket that terminated below the groin and the tuber ischiadicum. Radiographs showed improved alignment of the amputated leg (Figure 2) and the patient reported only minor stump pain, even with full endbearing. The skin was normal, probably because of the large bearing surface of the artificial condyle (Jensen 1996).