Fracture of the polyethylene tibial post in posterior stabilized (Insall Burstein II) total knee arthroplasty

Mestha, P.; Shenava, Y.; D'Arcy, J.C.

doi:10.1054/arth.2000.6615

Cited by 82 publications

(43 citation statements)

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“…Several reports [1–6] exist of the failure of the tibial post in the posteriorstabilised TKA (PS-TKA) using a cam and postmechanism. Although this is a rare case of a fracture of the metallic femoral condylar component in a total knee replacement, the complication is a reminder to us of the possibility and further assessment.…”

Section: Discussionmentioning

confidence: 99%

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

Swamy

Quah

Bagouri

et al. 2014

Case Reports in Orthopedics

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This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before.

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Section: Discussionmentioning

confidence: 99%

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

Swamy

Quah

Bagouri

et al. 2014

Case Reports in Orthopedics

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“…Use of HXLPE in TKAs could increase the risk of fracture of the tibial polyethylene insert at an articular or nonarticular region given the lower material toughness that stems from more polymer crosslinks [17][18][19]. However, the polyethylene of these HXLPE implants customarily is treated to make the material more resistant to mechanical failure secondary to oxidative degradation [14,17,19].…”

Section: Introductionmentioning

confidence: 99%

Highly Crosslinked-remelted versus Less-crosslinked Polyethylene in Posterior Cruciate-retaining TKAs in the Same Patients

Kim

Park

Kim

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Concern regarding osteolysis attributable to polyethylene wear after TKA, particularly in younger patients, has prompted the introduction of highly crosslinkedremelted polyethylene (HXLPE) for TKAs. However, few in vivo comparative results of TKAs using HXLPE and less-crosslinked polyethylene inserts in the same patients are available, regarding fracture or failure of the locking mechanism of tibial polyethylene inserts or of osteolysis in patients younger than 60 years. Questions/Purposes We wanted to determine whether (1) survivorship free from aseptic loosening in knees with HXLPE inserts was different from survivorship in knees with less-crosslinked polyethylene inserts, (2) the prevalence of fracture or failure of the locking mechanism of the tibial polyethylene insert was greater in knees with HXLPE than in those with less-crosslinked polyethylene, and (3) the proportion of patients who had osteolysis develop was greater with HXLPE than with less-crosslinked polyethylene inserts. Methods One hundred seventy-one patients with a mean age of 58 ± 8 years (range, 35À59 years) received posterior cruciate-retaining prostheses with a less-crosslinked polyethylene tibial insert in one knee and a HXLPE tibial insert in the contralateral knee. From January 2007 to January 2010, we performed 366 same-day bilateral simultaneous sequential posterior cruciate-retaining TKAs in 183 patients, of whom 171 (93%) participated in this study. All patients during this study period underwent posterior cruciate-retaining TKAs regardless of deformity of the knees and we did not perform posterior-stabilized TKAs during the same period. Patients who had bilateral end-stage osteoarthritis and were younger than 60 years were selected for inclusion. Six patients (4%) were lost to followup before 5 years. Twenty-six patients were males and 145 were females. The mean duration of followup was 6 years (range, 5À8 years). At each followup, patients were assessed for loosening of the components, fracture or failure of the locking mechanism of the polyethylene inserts, or osteolysis. Results The survival rate of the knee prosthesis at a mean of 5.8 years after surgery was 100% (95% CI, 0.95-1.00) in both groups for the endpoint aseptic loosening and 99.4% (95% CI, 0.95-1.00) in both groups for the endpoint revision. No knee in either group had fracture or failure of the locking mechanism of the tibial polyethylene insert, and none had osteolysis. Conclusions With the numbers available, we found no clinically important differences between HXLPE and lesscrosslinked polyethylene inserts in posterior cruciate-

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“…These patients were treated by revision using a deep-dish congruent tibial liner, with a mean followup of 28 months (range, 13-61 months). There were eight different posteriorstabilized prostheses in the 27 other cases of tibial post fractures: 11 Insall-Burstein II1 [9,14,15,20,28], one Insall-Burstein I1 [14], three NexGen1 (all Zimmer) [8,11,23], four Scorpio1 (Stryker, Mahwah NJ, USA) [17,18,25], four Genesis1 (Smith & Nephew, Memphis, TN, USA) [19,26,30], two PFC-Sigma1 [3,32], one AMK (both DePuy, Warsaw IN, USA) [29], and one DualArticular1 [5] …”

Section: Resultsmentioning

confidence: 99%

How to Treat A Tibial Post Fracture in Total Knee Arthroplasty?

Lachiewicz

2011

Clinical Orthopaedics &Amp; Related Research

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Fracture of the polyethylene tibial post in posterior stabilized (Insall Burstein II) total knee arthroplasty

Cited by 82 publications

References 0 publications

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

Highly Crosslinked-remelted versus Less-crosslinked Polyethylene in Posterior Cruciate-retaining TKAs in the Same Patients

How to Treat A Tibial Post Fracture in Total Knee Arthroplasty?

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