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Case Reports
. 2021 Apr 14:8:222-225.
doi: 10.1016/j.artd.2021.03.006. eCollection 2021 Apr.

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

Ricardo Ocampo  1 , Eric Azua  2 , Matthew Presti  1 , Lynn Voss  1
Affiliations
Case Reports

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

Ricardo Ocampo et al. Arthroplast Today. .

Abstract

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.

Keywords: Atraumatic; Femoral component; Fracture; Medial condyle; TKA.

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Figures

Figure 1
Figure 1
(a) Radiograph AP view of the left knee showing significant wear of the medial polyethylene insert with contact between the medial femoral and tibial components. (b) Radiograph lateral view of the left knee demonstrating fracture of the medial condyle of the Advance Medial-Pivot Knee System prosthesis (indicated with the red arrow). (c) Radiograph sunrise view of the left knee demonstrates a complete fracture of the medial condyle of the Advance Medial-Pivot Knee System prosthesis.
Figure 2
Figure 2
CT scan with MAR and 3D reconstruction demonstrates a medial condyle fracture of the Advance Medial-Pivot Knee System prosthesis (indicated with the red arrow).
Figure 3
Figure 3
Intraoperative photograph displaying the fractured medial component of the Medial-Pivot Knee System. In particular, this photo shows that loose medial component flipped 180 degrees.
Figure 4
Figure 4
Intraoperative photograph displaying the fractured medial component of the Medial-Pivot Knee System once the prosthesis was fully extracted.
Figure 5
Figure 5
Intraoperative photograph displaying the severe medial polyethylene wear.
Figure 6
Figure 6
(a) Postoperative radiograph AP view displaying the new Triathlon Total Stabilizer (Stryker Orthopedics, Kalamazoo, MI) implant. (b) Postoperative radiograph lateral view displaying the new Triathlon Total Stabilizer (Stryker Orthopedics, Kalamazoo, MI) implant.
See this image and copyright information in PMC

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