scholarly journals Fracture of the Tibial Baseplate 16 Years after Miller-Galante II Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Kazuaki Mineta ◽  
Masahiko Okada ◽  
Soshi Matsumoto ◽  
Daisuke Hamada ◽  
Tomohiro Goto ◽  
...  

We report a rare case of tibial baseplate fracture of Miller-Galante II (MG II) prosthesis. We examine the factors that may cause such late fracture and review the literature on radiographic analysis and retrieval studies. A 76-year-old woman, who had undergone bilateral MG II total knee arthroplasty due to rheumatoid arthritis 16 years earlier, presented to our department with a 3-month history of left knee pain. Plain radiographs revealed severe distortion of the medial tibial component. During revision knee arthroplasty, we observed severe metallosis in the knee joint, polyethylene insert deformation, and posteromedial coronal baseplate fracture. After removal of the fractured tray, a bone deficit due to osteolysis was noted. The revision prosthesis (LCCK, Zimmer-Biomet) was implanted uneventfully. Four months after revision surgery, the patient was ambulating and had no complications. The implants on the right side had survived without complications for 17 years. We speculate that the primary causative factor of the fatigue fracture of the base plate due to loss of bony support most likely secondary to osteolysis was varus malalignment at primary implantation. This case highlights the importance of paying close attention to the correct alignment of each component at primary implantation.

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Girish N. Swamy ◽  
Conal Quah ◽  
Elmunzar Bagouri ◽  
Nitin P. Badhe

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before.


Joints ◽  
2019 ◽  
Vol 07 (01) ◽  
pp. 013-018
Author(s):  
Davide E. Bonasia ◽  
Anna Palazzolo ◽  
Umberto Cottino ◽  
Francesco Saccia ◽  
Claudio Mazzola ◽  
...  

AbstractTotal knee arthroplasty (TKA) is a valuable treatment option for advanced osteoarthritis in patients unresponsive to conservative treatments. Despite overall satisfactory results, the rate of unsatisfied patients after TKA remains high, ranging from 5 to 40%. Different modifiable and nonmodifiable prognostic factors associated with TKA outcomes have been described. The correction, whenever possible, of modifiable factors is fundamental in preoperative patients' optimization protocols. Nonmodifiable factors can help in predicting the outcomes and creating the right expectations in the patients undergoing TKA. The goal of this review is to summarize the modifiable and nonmodifiable prognostic factors associated with TKA outcomes.


Knee Surgery ◽  
2014 ◽  
pp. 1-1
Author(s):  
Michael Kelly ◽  
Yair Kissin

Author(s):  
Ioannis Gkiatas ◽  
Thomas P. Sculco ◽  
Peter K. Sculco

2016 ◽  
Vol 30 (06) ◽  
pp. 600-605 ◽  
Author(s):  
Lih Wang ◽  
Sungsoo Kim ◽  
Kyungtaek Kim ◽  
Seunghyun Lee ◽  
Kyungho Lee ◽  
...  

AbstractWe investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed. There were significant statistical difference between two groups just in age, history of dementia, cerebrovascular disease, difference of hemoglobin and albumin, start time of walking, and duration of hospital stay. The delirium after TKA delays the postoperative ambulation and extends the hospital stay, which causes functional and socioeconomic loss of patients. Therefore, the risk factors for delirium should be assessed and proper prevention and management should be conducted.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Joseph C. Brinkman ◽  
Kade S. McQuivey ◽  
Justin L. Makovicka ◽  
Joshua S. Bingham

We present a case of an 82-year-old female with a history of right total knee arthroplasty 11 years prior. She was admitted after a ground-level fall and developed progressive pain and swelling of her right knee. She had no history of complications with her total knee replacement. Radiographs of the knee and hip were negative for acute fracture, dislocation, or hardware malalignment. Knee aspiration was performed and revealed inflammatory exudate, synovial fluid consistent with crystal arthropathy, and no bacterial growth. She was diagnosed with an acute gout flare, and her symptoms significantly improved with steroids and anti-inflammatory treatment. Orthopedic surgeons should be aware of the potential for crystal arthropathy in the setting of total joint arthroplasty and evaluate for crystals before treating a presumed periprosthetic joint infection.


Author(s):  
Luca Amendola ◽  
Domenico Tigani ◽  
Matteo Fosco ◽  
Dante Dallari

2019 ◽  
Vol 15 (4) ◽  
pp. 287-290
Author(s):  
Ruku Pandit ◽  
Nitasha Sharma

Background: Total knee arthroplasty is the most cost effective and rapidly evolving technique. The success of procedure relies on appropriate sizing of tibial component, for which elaborate information of various dimensions of upper surface of tibia is mandatory. Hence, this study is aiming to generate baseline data on antero-posterior and transverse measurements of medial and lateral condyles and intercondylar area of upper surface of tibia. Methods: The study was conducted in 42 dry human cadaveric tibia with unidentified age and sex, in the Department of Anatomy, College of Medical Sciences and Teaching Hospital, Chitwan. The antero-posterior and transverse measurements of medial and lateral condyles and intercondylar area of tibia were recorded in millimeter (mm) with digital Vernier calipers. The data was analysed using SPSS version 16.0. Results: The antero-posterior and transverse measurements of medial condyle of tibia were 43.00±5.95 mm and 25.21±8.08 mm respectively on the right side and 45.33±5.36 mm and 27.43±8.57 mm respectively on the left side and that of lateral condyle were 37.94±5.64 mm and 25.21±8.71 mm respectively on the right side and 41.03±3.65 mm and 27.06±8.83 mm respectively on the left side. The antero-posterior and transverse measurements of intercondylar area of tibia were 47.49±6.31 mm and 15.71±3.93 mm respectively on the right side and 49.24±6.91 mm and 15.02±3.88 mm respectively on the left side. The variation in the measurements between right and left tibia showed significant difference only for antero-posterior measurement of lateral condyle (p<0.05). Conclusions: The study generates baseline data regarding various anthropometric measurements of upper surface of tibia, which will assist the orthopedic surgeon to create a resected bony surface identical to the tibial component of an implant in unilateral and total knee arthroplasty. Keywords: measurement; morphometric; superior articular surface; tibial condyles.


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