Fracture of the proximal tibia after revision total knee arthroplasty with an extensor mechanism allograft.
Extensor mechanism reconstruction with an extensor mechanism allograft (EMA) remains one of the most reliable methods for treating the extensor mechanism deficient total knee arthroplasty. We report 3 patients who were treated with an EMA who sustained a proximal tibial shaft fracture. In all 3 cases, a short tibial component was present that ended close to the level of the distal extent of the bone block. When performing an EMA, it is important to recognize that the tibial bone block creates a stress riser and revision to a long-stemmed tibial component should be strongly considered to bypass this point to minimize the risk of fracture.
Hartzband Center for Hip and Knee Replacement and Hackensack University Medical Center, Hackensack, New Jersey, USA.
Gregg R
GR
Klein
Harlan B
HB
Levine
Scott M
SM
Sporer
Mark A
MA
Hartzband
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000293:injuries / Q000637:transplantation*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D012086:Reoperation; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000293:injuries / Q000601:surgery* / Q000637:transplantation; D013978:Tibial Fractures / Q000209:etiology / Q000601:surgery*; D014184:Transplantation, Homologous