title: Fatigue fracture of tibial arthroplasty implant masked by contralateral knee arthritis.
abstract: BACKGROUND
  The wear of polyethylene components is a well-recognised long-term complication of total knee arthroplasty.
  
  
  METHODS
  We present a case of fatigue fracture of a geomedic tibial tray 17 years after implantation. The symptoms were masked by primary osteoarthritis of the contralateral knee.
  
  
  CONCLUSIONS
  The mode of failure in this case differs from that most commonly reported in the literature in that it occurred late as the result of prolonged use, not due to implant failure, physiological factors, or surgical technique. The case also demonstrates the incredible 'masking' effect of arthritic knee pain.
  
  
  CONCLUSIONS
  This case highlights the importance to clinicians of keeping a high index of suspicion for prosthesis complications in patients with unilateral joint replacement with contralateral arthropathy.
authors.affiliation: Department of Orthopaedic Surgery, The Adelaide & Meath Hospital Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: barryoneill1922@gmail.com.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: O'Neill
authors.forename: May
authors.initials: M
authors.lastname: Cleary
authors.forename: John P
authors.initials: JP
authors.lastname: McElwain
references.citation: Acta Orthop. 2010 Aug;81(4):463-70
references.pmid: 20809744
references.citation: Acta Orthop Scand. 1995 Dec;66(6):513-6
references.pmid: 8553818
references.citation: J Arthroplasty. 2005 Dec;20(8):1084-8
references.pmid: 16376269
references.citation: J Clin Densitom. 2004 Winter;7(4):424-31
references.pmid: 15618604
references.citation: J Bone Joint Surg Am. 2012 Oct 17;94(20):1839-44
references.pmid: 23079875
references.citation: J Bone Joint Surg Br. 2003 Sep;85(7):975-9
references.pmid: 14516030
references.citation: J Arthroplasty. 2006 Oct;21(7):1068-71
references.pmid: 17027553
references.citation: J Arthroplasty. 2001 Oct;16(7):927-34
references.pmid: 11607912
references.citation: J Med Assoc Thai. 2012 May;95(5):667-73
references.pmid: 22994026
references.citation: J Bone Joint Surg Br. 2007 Jun;89(6):742-5
references.pmid: 17613497
references.citation: J Arthroplasty. 2001 Oct;16(7):893-900
references.pmid: 11607906
references.citation: J Arthroplasty. 2004 Sep;19(6):797-802
references.pmid: 15343544
references.citation: J Arthroplasty. 2008 Feb;23(2):188-96
references.pmid: 18280411
references.citation: J Bone Joint Surg Am. 1982 Sep;64(7):1026-33
references.pmid: 7118966
references.citation: Clin Orthop Relat Res. 1988 Mar;(228):182-9
references.pmid: 3342564
references.citation: J Bone Joint Surg Am. 1984 Jun;66(5):780-2
references.pmid: 6725329
references.citation: Clin Orthop Relat Res. 1986 Aug;(209):244-8
references.pmid: 3731605
references.citation: Orthopedics. 2011 Oct 05;34(10):e688-91
references.pmid: 21956069
references.citation: J Arthroplasty. 2007 Jun;22(4):612-6
references.pmid: 17562423
references.citation: J Arthroplasty. 2007 Aug;22(5):780-3
references.pmid: 17689793