Fracture of the Femoral Component in TKR – A Case Report

Abstract

Femoral component fracture in total knee replacement (TKR) is a rare complication. In the majority of case reports, stress fractures of the femoral component have predominantly affected the medial condyle, following uncemented implantation of fixed-bearing knees. We report the case of fracture of the lateral condyle of a cemented fixed TKR due to bad cementing technique.

Atraumatic Fracture of the Medial Femoral Condyle of a Total Knee Arthroplasty

“…As the number of people with high BMI in the United States as well as in other parts of the world continue to increase, we agree with Schuh et al. who postulate that total knee revisions due to fatigue fractures will continue to increase and become a more prevalent complication [ 4 ]. This is also likely the reason why there has been an increase in reported femoral component fractures within the last few years.…”

“…The failure of a total knee arthroplasty (TKA) component is a rare occurrence and comprises less than 1% of indications for a revision TKA [ 1 ]. However, when component failure does occur, it is more commonly present in the tibial component or the polyethylene insert on the tibia, as opposed to the femoral component [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] ]. An isolated fracture of the femoral component is rare, and only a few reports have been documented.…”

“…Schuh et al. reported a fracture of the lateral condyle of a cemented fixed TKA which they attributed to poor cementing technique [ 4 ]. In 2016, Thompson emphasized how an isolated fracture of a femoral component is a rare event and described another case in which the medial femoral condyle was fractured [ 2 ].…”

“…However, Thompson attributed the component failure to a traumatic event involving the patient pushing a broken-down car down a highway [ 2 ]. Since 2019, more case reports have been published detailing the mechanisms of femoral component fracture; however, this is the first known case in which the medial femoral condyle fractured atraumatically in an Advance Medial-Pivot Knee System (MicroPort Orthopedics, Arlington, TN) [ 4 , [6] , [7] , [8] , [9] ].…”