Medial Midstem Pivot

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- Discussion:
  - proximal medial, distal lateral shift (medial mig)
  - stem rotates around the center point;
  - medial stem pivot is caused by medial migration of proximal portion of
      femoral stem;
  - lateral migration of the distal tip results from inadequate superomedial
      and inferolateral cement support;
  - this may produce a fracture of the cement at midstem and of sclerotic
      bone lateral to the tip of the stem;