Atraumatic Fracture of the Femoral Component of a Cemented Total Knee Arthroplasty

Abstract

Case: An 81-year-old man presented with severe atraumatic knee pain. Sixteen years before, he had undergone a primary cemented total knee arthroplasty (TKA). A radiological study showed osteolysis and loosening of the femoral component. Intraoperatively, a medial femoral condyle fracture was found. A rotating-hinge revision TKA with cemented stems was implanted. Conclusion:Femoral component fracture is extremely rare. Surgeons should remain vigilant with younger and heavier patients with severe unexplained pain. Early revision TKA using cemented, stemmed, and more constrained implants is usually necessary. Full and stable metal-to-bone contact through perfect cuts and a careful cementing technique avoiding debonded areas are recommended to prevent this complication.