Fracture and Posterior Dislocation of Meniscal Bearing Insert in Mobile Bearing Unicompartmental Knee Arthroplasty: A Case Report

Munjal, Akul

doi:10.5704/moj.1807.013

Cited by 6 publications

(11 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The final use of a 4 mm meniscus bearing was able to achieve knee stability without varus or valgus, and the meniscus bearing did not lift off. This management strategy was consistent with previous reports 11,12 . We conducted a comprehensive literature review to elucidate similar cases and to gain insights into optimal management strategies (Table 1).…”

Section: Discussionsupporting

confidence: 73%

“…This is usually related to the selection of surgical indications, poor implant position, imbalance of flexion and extension gaps, and other factors. However, meniscal bearing fractures are rare in mobile bearing UKA, as it can result in knee instability and failure, and there are only few related reports 11–13 . This is usually because of long‐term wear of the bearing, use of thin polyethylene bearing for the initial surgery, and postoperative traumatic overloading.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Challenges in Residual Bearing Removal: A Rare Case of Mobile Bearing Fracture in Unicompartmental Knee Arthroplasty with Literature Review

Shen,

Zhang,

Liu

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

BackgroundMobile bearing fracture is a rare long‐term complication of unicompartmental knee arthroplasty (UKA), and relevant reports are sparse. Hence, its treatment options need further exploration.Case PresentationThis study presents the case of fracture of a polyethylene insert that occurred 12 years after mobile bearing medial UKA in a 75‐year‐old overweight woman who then underwent surgical intervention at our institution. However, we encountered significant challenges in removing the fragments from the broken bearing, resulting in retention of the remaining one‐third of the fragment. We solved this problem by replacing the fractured insert with thicker mobile bearing. During the 1‐month postoperative follow‐up, the patient achieved good range of motion and excellent satisfaction, with no reported complications and a Knee Society Score of 90. Additionally, we reviewed the literature on the treatment for mobile bearing fractures after UKA.ConclusionsBearing fracture is a rare cause of failure of mobile bearing UKA. This case highlights the challenges of UKA fracture bearing retrieval and underscores that mobile bearing replacement can be an effective intervention. The case we report shows that when removal of a residual meniscal bearing in a posterior dislocation is difficult to achieve, compromise may be an appropriate option because it does not cause additional complaints to the patient. This case emphasizes the importance of the surgeon having a thorough preoperative understanding of the location and potential pitfalls of fracture fragments in such situations.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Challenges in Residual Bearing Removal: A Rare Case of Mobile Bearing Fracture in Unicompartmental Knee Arthroplasty with Literature Review

Shen,

Zhang,

Liu

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Mechanisms leading to dislocation include deep flexion, injury, rolling over during sleep; 41 however, most patients do not recall an event. 42 , 43 Several types of bearing dislocation have been reported, including: anterior (most common), 40 posterior, 40 , 42 into the condylar notch or subluxation onto the lateral wall of the tibial tray, 41 , 43 subluxation by upward tilting of the bearing on the medial side, 44 a few cases with a bearing fracture with one piece anteriorly and one piece posteriorly displaced, 40 , 45 and 180° spin. 46 Spontaneous relocation of a posterior dislocation has been reported.…”

Section: Resultsmentioning

confidence: 99%

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

et al. 2021

View full text Add to dashboard Cite

Unicompartmental knee arthroplasty (UKA) has several advantages over total knee arthroplasty; however, in many reports, the risk of revision remains higher after UKA. Many reasons for failure of UKA exist. Successful treatment starts with accurate assessment of the symptomatic UKA as a specific mode of failure requires a specific solution. A structured and comprehensive evaluation aids assessment of the symptomatic UKA. This review provides an overview of the causes for a symptomatic medial UKA, its risk factors, diagnostic modalities that can be used, and briefly discusses treatment options. Cite this article: EFORT Open Rev 2021;6:850-860. DOI: 10.1302/2058-5241.6.200105

show abstract

“…Excessive linear wear may result in bearing fracture, which although a rare complication, has been increasingly reported for Phase 3 OUKRs compared with Phase 2 [2][3][4]31]. This may be a result of an increased wear rate but is also likely a consequence of the operation being done in younger patients with increasing life expectancy, with most reported bearing fractures occurring in the second or third postoperative decade.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the use of thin bearings wear is a rare cause of failure for the OUKR [1]. Excessive linear wear can result in bearing fracture in the long-term, however this complication can easily be treated by inserting a new bearing [2][3][4]. The main disadvantage of a mobile bearing is dislocation, but this is also rare (~1%) [5].…”

Section: Introductionmentioning

confidence: 99%

Polyethylene bearing wear is comparable for cemented and cementless Oxford unicompartmental knee replacements: Ten‐year results of a randomized controlled trial

Arthur,

Ghosh,

Mohammad

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThere is concern that using cementless components may increase polyethylene wear of the Oxford unicompartmental knee replacement (OUKR). Therefore, this study aimed to measure bearing wear at 10 years in patients from a randomized trial comparing Phase 3 cemented and cementless OUKRs and to investigate factors that may affect wear. It was hypothesized that there would be no difference in wear rate between cemented and cementless OUKRs.MethodsBearing thickness was determined using radiostereometric analysis at postoperative, 3‐month, 6‐month, 1‐year, 2‐year, 5‐year and 10‐year timepoints. As creep occurs early, wear rate was calculated using linear regression between 6 months and 10 years for 39 knees (20 cemented, 19 cementless). Associations between wear and implant, surgical and patient factors were analysed.ResultsThe linear wear rate of the Phase 3 OUKR was 0.06 mm/year with no significant difference (p = 0.18) between cemented (0.054 mm/year) and cementless (0.063 mm/year) implants. Age, Oxford Knee Score, component size and bearing thickness had no correlation with wear. A body mass index ≥ 30 was associated with a significantly lower wear rate (p = 0.007) as was having ≥80% femoral component contact area on the bearing (p = 0.003). Bearings positioned ≥1.5 mm from the tibial wall had a significantly higher wear rate (p = 0.002).ConclusionsAt 10 years, the Phase 3 OUKR linear wear rate is low and not associated with the fixation method. To minimize the risk of wear‐related bearing fracture in the very long‐term surgeons should consider using 4 mm bearings in very young active patients and ensure that components are appropriately positioned, which is facilitated by the current instrumentation.Level of EvidenceLevel III, Retrospective Comparative Study.

show abstract

Fracture and Posterior Dislocation of Meniscal Bearing Insert in Mobile Bearing Unicompartmental Knee Arthroplasty: A Case Report

Cited by 6 publications

References 5 publications

Challenges in Residual Bearing Removal: A Rare Case of Mobile Bearing Fracture in Unicompartmental Knee Arthroplasty with Literature Review

Challenges in Residual Bearing Removal: A Rare Case of Mobile Bearing Fracture in Unicompartmental Knee Arthroplasty with Literature Review

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

Polyethylene bearing wear is comparable for cemented and cementless Oxford unicompartmental knee replacements: Ten‐year results of a randomized controlled trial

Contact Info

Product

Resources

About