Giant Bone Island of Femur Complicating Replacement Arthroplasty: A Report of Two Cases

Bone islands are hamartomatous malformations in the bone that are known to be asymptomatic in nature. Two cases are presented in which the presence of bone islands in the femur led to difficulty with the introduction of a femoral prosthesis. In one case, this led to fracture of the medial part of the cortex, which was fixed with a screw prior to insertion of the prosthesis. In the second case, a window was made in the femur to remove hard bone sufficient for insertion of the prosthesis. This was closed with steel wires prior to insertion of the cemented femoral stem. These cases illustrate the problems that can be encountered during surgery in the presence of bone islands. The surgeon should evaluate the site, size, and location of bone islands during preoperative planning before performing surgery. (Journal of Surgical Orthopaedic Advances 13(4):220–223, 2004)