Femoral component fracture due to osteolysis after cemented mobile-bearing total knee arthroplasty.
A 58-year-old man with osteoarthritis in the left knee underwent a total knee arthroplasty with a New Jersey anterior-posterior gliding low contact stress mobile-bearing implant. All femoral, tibial, and patellar components were implanted with bone cement. Pain developed at 43 months postsurgery, and plain radiography revealed a vertical crack in the femoral component and osteolysis at the medial femoral condyle. The femoral and tibial components were revised, and the bone defect at the medial femoral condyle was reconstructed using an allogeneic strut bone graft. Microscope examination identified polyethylene particles with foreign body granulomatous reaction, and scanning electron microscopy revealed fatigue failure of the femoral component. Osteolysis due to polyethylene particles can lead to fracture of the femoral component after cemented anterior-posterior gliding low contact stress mobile-bearing total knee arthroplasty.
Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, South Korea.
Chang Dong
CD
Han
Chang Wook
CW
Han
Ik Hwan
IH
Yang
D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D001843:Bone Cements; D005264:Femoral Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000139:chemically induced / Q000150:complications*; D020959:Polyethylene / Q000009:adverse effects; D011859:Radiography; D012086:Reoperation; D013314:Stress, Mechanical
D001843:Bone Cements; D020959:Polyethylene