scholarly journals Fatigue failure of the femoral component of a total knee arthroplasty: a case report and review of the literature

2020 ◽  
Author(s):  
W Greeff ◽  
RDV Greeff ◽  
CT Frey ◽  
V Singh
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Case Report ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Pain ◽  
Fatigue Failure ◽  
Knee Arthroplasty ◽  
English Literature ◽  
Total Knee

ABSTRACT INTRODUCTION: Reports of fatigue failure of the femoral component of a total knee arthroplasty (TKA) is scanty in the literature. As a result, there are no clearly defined risk factors to aid us in predicting fatigue failure of an implant. Furthermore, these patients may present with non-specific knee pain, which may or may not be well tolerated, depending on the stability of the implant. We report a case of fatigue failure of a poorly cemented femoral component of a TKA in a 72-year-old female, approximately seven years after the initial surgery CASE REPORT: A 72-year-old female presented to our tertiary level arthroplasty unit with new-onset knee pain approximately seven years after undergoing a TKA at our unit. She reported hearing a crack six months earlier, while standing up from a seated position. She had initially presented to her local clinic, but the pathology was missed. She received revision surgery at our institution and was doing well at early follow-up. DISCUSSION: We reviewed the literature on fatigue failure of femoral components in TKA in an attempt to define risk factors. We also summarised all cases of femoral component fatigue failure in the English literature. CONCLUSION: Although femoral component fatigue failure in TKA is rare, the majority of cases have attributed the failure to poor surgical technique. Despite this, certain implants have been failing more often than others, and proposed mechanisms for this exist. Orthopaedic surgeons need to be aware of which implant designs are prone to failure, as well as how meticulous surgical technique can reduce the chances of fatigue failure. Level of evidence: Level 5 Keywords: femoral component, total knee arthroplasty, fatigue failure, stress fracture

scholarly journals Association Between Femoral Component Sagittal Positioning and Anterior Knee Pain in Total Knee Arthroplasty

2019 ◽  
Vol 101 (17) ◽  
pp. 1575-1585 ◽  
Author(s):  
Chloe E.H. Scott ◽  
Nicholas D. Clement ◽  
Liam Z. Yapp ◽  
Deborah J. MacDonald ◽  
James T. Patton ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Total Knee ◽  
Anterior Knee

scholarly journals Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

2014 ◽  
Vol 4 (2) ◽  
pp. 29-36
Author(s):  
Edward McPherson, MD FACS ◽  
Denise Portugal, MD ◽  
Matthew Dipane, BA ◽  
Sherif Sherif, MD
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Primary Total Knee Arthroplasty ◽  
Implant Design ◽  
Consecutive Series ◽  
High Flexion ◽  
Total Knee

This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA) procedures utilizing a technique to optimize knee flexion.  The main features include: (1)the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2) patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3)a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4)incorporation of a rapid recovery protocol with features to promote knee flexion.Results were categorized into three groups: low pre-op flexion (90 degrees and below), regular pre-op flexion (91-125 degrees), and high pre-op flexion (126 degrees and above).  Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years.  In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years.  Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years.In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.Keywords: Total knee arthroplasty, range of motion, high flexion, surgical technique, implant design, AP AxisLevel of Evidence:  AAOS Therapeutic Study Level III

scholarly journals A rare etiology of posterolateral pain subsequent to a total knee arthroplasty

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Olden Theresa Rebecca ◽  
◽  
Vallotton, Jacques ◽  
Keyword(s):  
Total Knee Arthroplasty ◽  
Differential Diagnosis ◽  
Case Report ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Postoperative Outcome ◽  
Surgical Removal ◽  
Keywords Total Knee Arthroplasty ◽  
Total Knee ◽  
Posterolateral Knee Pain

This case report illustrates a very rare problematic after Total Knee Arthro-plasty (TKA), yet that you have to think of if posterolateral pain appears. The postoperative outcome of our patient was initially very good, but pain appeared after 6 weeks, in an atypical mode, that couldn’t be attributed to the most common differential diagnosis. The characteristics of the symptoms directed us to a mechanical cause and the solution finally came up by means of a radiography: the images showed an impingement between one of the tibial tuberosity fixation screw’s head and the fibular neck. What couldn’t be seen on the primary images was an irritating callus, that was detected at 3 months postoperatively. The pain disappeared after surgical removal of the screw. Keywords: Total knee arthroplasty; Posterolateral knee pain; Pain after total knee ar-throplasty; Tibial screw impingement.

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