Femoral perforation complicated by pedestal formation in revision hip arthroplasty

We present a case report of a patient in whom intra-operative penetration of the femoral cortex occurred during revision hip surgery. We report this to highlight that femoral perforation can occur at the pedestal while reaming the femoral canal during revision arthroplasty. Distal pedestal, the thick endosteal bone bridge at the tip of the previous stem is often difficult to ream during revision and forcible reaming may perforate the femur. Adequate two view plain radiographs should be taken intra-operatively and the use of guide wires with flexible reamers is advised to avoid perforation.