Browse
Submit Data
Databases
API
Help

Dataset Information

24 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Nontraumatic fracture of the polyethylene tibial post in a bi-cruciate stabilized total knee prosthesis.

ABSTRACT: Tibial post fracture in total knee arthroplasty is a rare but disabling complication. The authors report a case of a nontraumatic fracture of the polyethylene tibial post in a patient with a bi-cruciate stabilized Journey total knee arthroplasty system with subsequent episodes of knee subluxation. Early revision is required to resolve this particular problem.

SUBMITTER: Renson D

PROVIDER: S-EPMC6728542 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Nontraumatic fracture of the polyethylene tibial post in a bi-cruciate stabilized total knee prosthesis.

Renson Daan D Lenaerts Wouter W Feyen Johan J

Arthroplasty today 20190723 3

Tibial post fracture in total knee arthroplasty is a rare but disabling complication. The authors report a case of a nontraumatic fracture of the polyethylene tibial post in a patient with a bi-cruciate stabilized Journey total knee arthroplasty system with subsequent episodes of knee subluxation. Early revision is required to resolve this particular problem. ...[more]

PMID: 31516966

Similar Datasets

Nontraumatic tibial polyethylene insert cone fracture in mobile-bearing posterior-stabilized total knee arthroplasty.

Project description:A 72-year-old male patient underwent mobile-bearing posterior-stabilized total knee arthroplasty for osteoarthritis. He experienced a nontraumatic polyethylene tibial insert cone fracture 27 months after surgery. Scanning electron microscopy of the fracture surface of the tibial insert cone suggested progress of ductile breaking from the posterior toward the anterior of the cone due to repeated longitudinal bending stress, leading to fatigue breaking at the anterior side of the cone, followed by the tibial insert cone fracture at the anterior side of the cone, resulting in fracture at the base of the cone. This analysis shows the risk of tibial insert cone fracture due to longitudinal stress in mobile-bearing posterior-stabilized total knee arthroplasty in which an insert is designed to highly conform to the femoral component.

| S-EPMC5247562 | biostudies-literature

Nontraumatic Tibial Polyethylene Insert Cone Fracture in Rotating-Platform Total Knee Arthroplasty.

Project description:We report a case of a fracture through the polyethylene (PE) insert cone in a rotating-platform (RP) primary total knee arthroplasty (TKA) implant. This is the first reported case of cone fracture with this particular implant. This case highlights a 65-year-old female presenting with a 4-month history of knee pain and symptoms of instability 10 years after primary RP TKA. At the time of revision surgery, the PE insert cone was found to be fractured 10 mm from the inferior surface of the PE liner. Analysis suggests that the cone fracture occurred by fatigue failure which caused loosening of the tibial tray. Clinicians should be aware that this is a potential cause of failure with an RP TKA in the setting of symptoms including instability and pain.

| S-EPMC8167323 | biostudies-literature

Traumatic Dislodgement of Tibial Polyethylene Insert after a High-Flex Posterior-Stabilized Total Knee Replacement.

Project description:Many pathologic entities can produce a painful total knee replacement (TKR) that may lead to potential prosthetic failure. Polyethylene insert dissociation from the tibial baseplate has been described most frequently after mobile-bearing and cruciate-retaining TKRs. However, only 3 tibial insert dislocations in primary fixed-bearing High-Flex posterior-stabilized TKRs have been reported. We present a new case of tibial insert dislocation in a High-Flex model that shares similarities and differences with the cases reported, facilitating the analysis of the potential causes, which still remain undefined.

| S-EPMC4592716 | biostudies-literature

Proximal tibial resorption in a modern total knee prosthesis.

Project description:Background:In an effort to minimize backside polyethylene wear and osteolysis associated with titanium tibial baseplates, many manufacturers have transitioned to cobalt chromium alloys. Recent literature has implicated thicker cobalt chromium designs as a potential source of increased stress shielding and resorption. We report the incidence of proximal tibial bone resorption in a large consecutive series of patients undergoing total knee arthroplasty, with a modern total knee design. Methods:Four hundred thirty-two consecutive primary total knee arthroplasties, performed by 2 fellowship-trained arthroplasty surgeons were identified over a 24-month period. In addition to review of the medical records, analysis of preoperative and postoperative radiographs was performed. Utilizing a novel classification system, the severity of resorption was quantified and correlated with patient and implant characteristics. Results:After exclusions, 339 knees were evaluated in 292 patients. Mean follow-up was 13.2 months (range 6-41). Resorption was present in 119 knees (35.1%). Average time to diagnosis of bone loss was 6.9 months (range 2-32) postoperatively. There was a statistically significant difference between resorption and nonresorption groups with regards to gender and preoperative alignment. Most cases were classified as Grade 1. During the study period, 2 patients required revision for aseptic tibial loosening. Conclusions:Our findings suggest that proximal tibial resorption is common with this particular implant, particularly in men and patients with preoperative varus deformity. Although this typically occurs relatively early in postoperative period and in most cases appears to remodel and stabilize, its ultimate clinical significance and effect on implant survivorship remains unclear.

| S-EPMC5994597 | biostudies-literature

Catastrophic Failures of the Tibial Post in a Bicruciate Substituting Total Knee Prosthesis.

Project description:Failure of the tibial post in a bicruciate substituting total knee prosthesis is a rare but catastrophic complication. The authors report 2 cases of a fracture of the polyethylene tibial post with subsequent episodes of knee subluxation. Prompt recognition and early revision of these complications are associated with a favorable early outcome.

| S-EPMC8079333 | biostudies-literature

Fracture of the insert cone of a polyethylene liner in a failed posterior-stabilized, rotating-platform total knee arthroplasty.

Project description:Failures unique to posterior cruciate-substituting total knee prostheses rarely include polyethylene post fractures but have been described. We report a case involving a fracture of the distal insert cone of a rotating-platform (RP) polyethylene liner in a primary total knee arthroplasty. This case highlights a 67-year-old male presenting with new-onset knee pain and recurrent effusions with osteolysis 11 years following placement of a posterior-stabilized, RP total knee arthroplasty. At the time of revision surgery, the polyethylene insert cone was found to be fractured just below the junction between cone and the body of the insert. Liner exchange, synovectomy, and osteolytic-defect curettage and cement packing were performed. One year following revision surgery, the patient is without pain and has returned to function without limitations. Clinicians must be aware of this possible failure with RP prostheses in the setting of pain with a stable knee, recurrent aseptic effusions, and osteolysis.

| S-EPMC5994790 | biostudies-other

Indications for bi-cruciate retaining total knee replacement: An international survey of 346 knee surgeons.

Project description:There is limited evidence on total knee arthroplasty (TKA) that retains the anterior and the posterior cruciate ligaments. Bi-cruciate retaining (BCR) TKA is considered to show improved clinical function and kinematics. This survey aimed to (1) identify interest in and acceptance of BCR TKA surgery and (2) to capture the range of indications for BCR in the opinion of practicing knee surgeons. 346 surgeons with experience in TKA surgery completed a bi-lingual online survey. Demographics, arthroplasty experience as well as acceptance of and indications for BCR TKA were collected. 53 surgeons were experienced in BCR TKA and 225 would consider implanting it. A mean of 19.5% of TKA patients were considered eligible for BCR TKA. 56.3% were thought to have intact ACL at the time of TKA surgery. Surgeons were not likely to perform BCR TKA in patients with inflammatory arthritis, aged over 80, BMI above 34.9 kg/m2, a varus or valgus deformity of more than 10° and flexion contractures of more than 10°. There is strong interest among orthopedic surgeons to perform BCR TKA and the percentage of potentially eligible patients is high. Significant joint deformity is a limitation of BCR TKA, while age and high BMI are less relevant. BCR TKA experienced surgeons are less restrictive.

| S-EPMC7295230 | biostudies-literature

Radiographic False Evidence of a Tibial Baseplate Fracture After Total Knee Arthroplasty.

Project description:Fracture of the tibial baseplate is a rare but dramatic cause of typically late fatigue failure in the setting of loosening after total knee arthroplasty. A 58-year-old female presented 4 months after total knee arthroplasty for evaluation of contralateral knee pain. Plain radiographs of the left knee incidentally suggested the possibility of tibial baseplate fracture despite minimal, expected postoperative symptoms. Subsequent computed tomography imaging demonstrated no confirmatory evidence of component failure or fracture. Malalignment and fatigue fracture are proposed etiologies of baseplate fractures. The presented case illustrates the importance of computed tomography imaging and clinical correlation when a diagnosis of baseplate fracture is suspected to avoid an unnecessary revision surgery.

| S-EPMC7943966 | biostudies-literature

Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty.

Project description:Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20-60 degrees ) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1 +/- 4.3 mm to 10.4 +/- 5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2 +/- 9.6 degrees to 49.3 +/- 7.3 degrees). Implanting the prosthesis increased the amount of anterior translation (to 16.1 +/- 4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0-60 degrees) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis.

| S-EPMC5507205 | biostudies-other

Migration of all-polyethylene compared with metal-backed tibial components in cemented total knee arthroplasty.

Project description:Background and purpose - With a rapidly increasing population in need of total knee arthroplasty (TKA), there is renewed interest in cost-saving all-polyethylene designs. Differences between metal-backed and all-polyethylene designs in initial component migration assessed by radiostereometric analysis (RSA), a proven predictor for late aseptic loosening, have been scantily reported. The purpose of this study was to compare implant migration and clinical outcomes of all-polyethylene tibial components versus metal-backed trays of similar geometrical shape. Patients and methods - In this randomized controlled trial, 59 patients received a cemented Triathlon condylar-stabilizing implant (Stryker, Mahwah, NJ, USA) with either an all-polyethylene (n = 29) or a metal-backed tibial component (n = 30). RSA measurements and clinical scores (the Knee Society Score, Forgotten Joint Score, and Knee Osteoarthritis and Injury Outcome Score) were evaluated at baseline and postoperatively at 3, 12, and 24 months. A linear mixed-effects model was used to analyze the repeated measurements. Results - A statistically significant difference in mean migration after 2 years was found in favor of the all-polyethylene group, with a mean maximum total point motion of 0.61?mm (95% CI 0.49-0.74) versus 0.81?mm (95% CI 0.68-0.96) for the cemented group (p = 0.03). However, this difference was smaller and not statistically significant after post hoc adjustment for surgeon effect. Both groups showed comparable improvements on all clinical outcome scores over time. Interpretation - The Triathlon all-polyethylene tibial component showed less migration, suggesting a lower risk of late loosening as compared with its metal-backed counterpart. However, the found surgeon effect warrants further investigation.

| S-EPMC6066763 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data