Fracture of the tibial tray following PCA knee replacement

Abstract

We report two cases in which fracture of the tibial metal tray was thought to be due to improper design of the tray and heavy polyethylene wear. The bone beneath the fractured portion of the tray was deficient and had been replaced by granulomatous fibrous tissue including numerous polyethylene wear particles and foreign-body giant cells. Osteolysis occurred as a tissue reaction to these particles.

Tibial Periprosthetic Fracture Combined With Tibial Stem Stress Fracture From Total Knee Arthroplasty

“…Scott et al (4) postulated that the varus implantation of the tibial component of a total knee arthroplasty increases the concentration of loads with their asymmetric distribution, and can cause a metal fatigue fracture. Also the implantation of the tibial component in external rotation was identified as responsible for excessive loads in tibial components, specifically in total condylar III knee (10) arthroplasties, as well as in the polyethylene fitting zone 5 , 11 , 12 .…”

Fracture of the Tibial Component in Total Knee Arthroplasty: Report on Two Cases

“…The two implants used in our study were of the same model made in the United States (Howmedica ® ). Flivik et al (10) and Maruyama et al (11) concluded from their studies that inappropriate design was the main factor involved in fracturing of the tibial component. In our study, the prosthesis used was of modern design, and what drew our attention was the similar fracture location in the two implants.…”

Fratura periprotética da tíbia combinada com fratura de fadiga da haste tibial de artroplastia total do joelho

“…Scott et al (4) postulated that the varus implantation of the tibial component of a total knee arthroplasty increases the concentration of loads with their asymmetric distribution, and can cause a metal fatigue frac- ture. Also the implantation of the tibial component in external rotation was identified as responsible for excessive loads in tibial components, specifically in total condylar III knee (10) arthroplasties, as well as in the polyethylene fitting zone (5,11,12) . The work of Maquet (13) demonstrated that, in the static position, varus knee deformity produces the exponential growth of loads transmitted to the medial tibial plate, not only through the increase of the lever arm but also through the decrease of the load-bearing surface.…”