title: Periprosthetic fracture of the tibia associated with osteolysis caused by failure of rotating patella in low-contact-stress total knee arthroplasty.
abstract: Periprosthetic fracture of the tibial plateau associated with osteolysis resulting from mechanical failure of the rotating patellar component after total knee arthroplasty with the New Jersey Low-Contact-Stress (LCS) knee (DePuy, Warsaw, IN) has not been reported previously. A 67-year-old woman with rheumatoid arthritis of the left knee had a LCS prosthesis implanted without cement, using a rotating patellar component. Seven years later, a fracture of the lateral tibial plateau occurred owing to an osteolytic defect with no traumatic accident. The rotating patellar bearing over-rotated and locked; consequently, wear occurred between the patellar metal tray and the femoral component. Immunohistochemistry revealed CD68-positive macrophages in the osteolytic region and phagocytosis of metal particles. The osteolytic region was filled with autogenous bone, and all components were exchanged and cemented. The patient's condition became satisfactory with relief of pain.
authors.affiliation: Division of Computer Integrated Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tomita
authors.forename: Masakazu
authors.initials: M
authors.lastname: Fujii
authors.forename: Motoharu
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sakaura
authors.forename: Eiji
authors.initials: E
authors.lastname: Takeuchi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D010014:Osteolysis / Q000209:etiology*; D010329:Patella; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013978:Tibial Fractures / Q000209:etiology*