Bilateral condyle fracture of tibial insert in mobile bearing total knee arthroplasty

Yoon, Joonsung; Jeong, Hyeon-Il; Oh, Kwang-Jun; Yang, Jae Hyuk

doi:10.1016/j.knee.2012.12.014

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Most early clinical reports of cross-linked polyethylene in TKR report favorable results, with good wear resistance [ 6 ]. However, there have been reports of fractures of highly cross-linked polyethylene in TKR, with all-polyethylene patellar components, at the tibial post of posterior stabilized tibial inserts, and across the condylar surface of CR inserts [ 7 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Fracture of Two Moderately Cross-Linked Polyethylene Tibial Inserts in a TKR Patient

Teeter

McAuley

Naudie

2014

Case Reports in Orthopedics

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Highly cross-linked polyethylene has become the gold standard in total hip replacement for its wear resistance. Moderately crosslinked polyethylene is now available for total knee replacement (TKR), although concerns about reduced mechanical strength have prevented widespread adoption. The purpose of this report is to describe an unusual case where a patient underwent cruciate retaining TKR using a moderately crosslinked polyethylene tibial insert that went on to fracture twice in the same location across the primary and first revision surgery. The first tibial insert was 10 mm thick and was implanted for 16 months. The second tibial insert was 15 mm thick and was implanted for 11 months. Both fractured along the posterior aspect of the medial articular surface. The lack of a specific event leading to these fractures and the fact that they occurred twice in the same location in the same patient suggest that caution is still necessary regarding the introduction of crosslinked polyethylene for TKR surgery.

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Section: Introductionmentioning

confidence: 99%

Fracture of Two Moderately Cross-Linked Polyethylene Tibial Inserts in a TKR Patient

Teeter

McAuley

Naudie

2014

Case Reports in Orthopedics

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“…They believe that limitation of the platform movement during the flexion, extension and rotation prevents dislocations and early failure of the insert. However, our studies showed some cases [17,24] where theoretically an increase in tibial insert failures should have been expected. Therefore, authors consider it not sufficient to rely only on kinematic limitations in clinical practice.…”

Section: Discussionmentioning

confidence: 59%

“…Despite multiple research, improvements in implants quality, surgical technique and clinical outcomes [6,14,16], based on own practical experience and some case reports contributed by other researchers [12,19,24] the authors consider that bio-physiological and biomechanical aspects of total knee arthroplasty and knee joint prosthesis should be thoroughly studied and implemented into the clinical practice. In the described cases, multiple damage of the insert due to flexion instability and "twist-hyperflexion" in overweight patients is perceived as the reason for failures.…”

Section: Discussionmentioning

confidence: 99%

Multiple Damage of the Tibial Polyethylene Insert in Knee Joint Prosthesis (Can Excellent Postoperative Outcome Be the Cause of Fracture of the Tibial Insert?) Case Report and Literature Review

Song

Eshnazarov²,

Асилова

et al. 2016

Traumatology and Orthopedics of Russia

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Despite improvements in prosthesis technology and use of high-quality materials in recent years, the number of revisions related to implant failures (4.7%) remains high. Several phenomena were reported in literature as reasons for dislocation and fracture of tibial insert in mobile bearing prosthesis: incorrect positioning of components, discrepancy of extension and flexion balancing or ligament weakness. However, in our cases neither of these causes were observed. The authors consider that bio-physiological and biomechanical aspects of total knee arthroplasty and knee joint prosthesis should be thoroughly studied and implemented into the clinical practice. In the described cases, multiple damage of the insert due to flexion instability and "twist-hyperflexion" in overweight patients is perceived as the reason for failures.

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Unsatisfactory clinical outcomes of second-generation mobile bearing floating platform total knee arthroplasty: comparing outcomes with fixed bearing after five years minimum

Yoon

Yang

2018

International Orthopaedics (SICOT)

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Bilateral condyle fracture of tibial insert in mobile bearing total knee arthroplasty

Cited by 4 publications

References 21 publications

Fracture of Two Moderately Cross-Linked Polyethylene Tibial Inserts in a TKR Patient

Fracture of Two Moderately Cross-Linked Polyethylene Tibial Inserts in a TKR Patient

Multiple Damage of the Tibial Polyethylene Insert in Knee Joint Prosthesis (Can Excellent Postoperative Outcome Be the Cause of Fracture of the Tibial Insert?) Case Report and Literature Review

Unsatisfactory clinical outcomes of second-generation mobile bearing floating platform total knee arthroplasty: comparing outcomes with fixed bearing after five years minimum

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