Loosening of a fenestrated femoral prosthesis: A case report with histomorphologic analysis

The explanted loose stem of a trabecular cementless femoral prosthesis (Holz-Copf) was histologically analyzed revealing soft tissue 3 mm thick between the metal of the prosthesis and the cancellous bone. Direct contact between the implant and bone could not be found. Removal of the prosthesis was impossible by simple extraction so that a transfemoral approach was required. Prostheses with large fenestrations may be loose but at the same time ingrown with sufficient bone to require invasive procedures for their removal.