Bilateral Femoral Component Fractures After Primary Total Knee Arthroplasty With Cruciate-Retaining Femoral Component

Atraumatic Fracture of the Femoral Component of a Cemented Total Knee Arthroplasty: A Case Report

CASE

An 81-year-old man presented with severe atraumatic knee pain. Sixteen years before, he had undergone a primary cemented total knee arthroplasty (TKA). A radiological study showed osteolysis and loosening of the femoral component. Intraoperatively, a medial femoral condyle fracture was found. A rotating-hinge revision TKA with cemented stems was implanted.

CONCLUSION

Femoral component fracture is extremely rare. Surgeons should remain vigilant with younger and heavier patients with severe unexplained pain. Early revision TKA using cemented, stemmed, and more constrained implants is usually necessary. Full and stable metal-to-bone contact through perfect cuts and a careful cementing technique avoiding debonded areas are recommended to prevent this complication.

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

The fracture of the femoral component is a rare complication of a total knee arthroplasty (TKA). This article presents a case in which a 70-year-old man underwent a left press-fit Advance Medial-Pivot Knee System TKA (MicroPort Orthopedics, Arlington, TN) in 2000. Twenty years later, he experienced a nontraumatic onset of knee pain after standing up from a lunge position. Radiographs and CT scans revealed a complete fracture of the medial condyle of the femoral component. Revision surgery was performed confirming the broken component. A cemented Triathlon Total Stabilizer (Stryker Orthopedics, Kalamazoo, MI) prosthesis was used for the revision. The authors recommend that surgeons maintain a high level of suspicion of component fracture when patients present with persistent severe knee pain and instability after a TKA.