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Between December 1996 and April 2003, 26 consecutive femoral component revisions in 24 patients were performed with an extensively hydroxyapatite-coated femoral stem. Two patients were lost to follow-up, and two patients died of unrelated causes. Of the 22 femoral revisions in 20 patients, there was a 0% incidence of mechanical loosening at average follow-up of 3.2 years (2–6.3 years). The Harris Hip Score improved from 59 (36 to 83) to 95 (84 to 100) postoperatively ( p < 0.001). Rate of revision was 18.2% (4.5% for sepsis, 9.1% for instability, and 4.5% for polyethelene wear). All 22 femoral components had evidence of bone ingrowth. The extensively coated hydroxyapatite stem in this series produced excellent clinical results with a low incidence of thigh pain (4.5%) and severe stress shielding (4.5%).

Tibiotalar dislocation without fracture is an unusual injury. Seventy-three cases have been reported in the literature. Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis is a very rare phenomenon. Eight cases have been reported. A case of this unique injury is presented, along with a literature review of purely ligamentous ankle dislocations. The proposed mechanism and classification of these injuries are summarized.