Fracture of the Tibial Baseplate in Bicompartmental Knee Arthroplasty

Abstract

Introduction. Bicompartmental knee arthroplasty (BKA) addresses combined medial and patellofemoral compartment osteoarthritis, which is relatively common, and has been proposed as a bridge between unicompartmental and total knee arthroplasty (TKA). Case Presentation. We present the case report of a young active man treated with BKA after unsuccessful conservative therapy. Four years later, loosening with fracture of the tibial baseplate was identified and the patient was revised to TKA. Discussion. Although our case is only the second fractured tibial baseplate to be reported, we believe that the modular titanium design, with two fixation pegs, is too thin to withstand daily cyclic loading powers. Light daily routine use, rather than high-impact sports, is therefore advised. Failures may also be related to the implant being an early generation and known to be technically complex, with too few implant sizes. We currently use TKA for the treatment of medial and patellofemoral compartment osteoarthritis.

Journey-Deuce bicompartmental knee arthroplasty with the addition of computer navigation achieves good clinical outcomes and implant survival at 10 years

“…Palumbo et al reported 14% of knees required revision to TKA at a mean 21 months post-surgery for persistent pain at the anterior medial aspect of the proximal tibia, with the authors also reporting that all tibial baseplates were grossly loose and easily explanted at the time of revision surgery [24]. The tibial baseplate was fractured in one which is a rare cause of implant failure in the knee but has been noted with the Journey-Deuce in other studies [36]. This demonstrates an inherent design law in the tibial component likely to be a baseplate that is too thin.…”