Callaghan John J, DeMik David E, Bedard Nicholas A, Odland Andrew N, Kane William M, Kurtz Steven M
Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
Mayo Clinic, Rochester, MN, USA.
Arthroplast Today. 2018 Feb 10;4(2):143-147. doi: 10.1016/j.artd.2017.12.005. eCollection 2018 Jun.
Fracture of the tibial tray is a rarely observed complication of total knee arthroplasty (TKA), predominately in implants placed greater than a decade ago. This case highlights a case of baseplate fracture in a contemporary prosthesis. The patient presented 1 year after TKA with medial knee pain consistent with pes bursitis. The implant-cement-bone construct was intact and she was managed with corticosteroids. She had persistent pain, acutely developed new varus deformity, and presented with a tibial tray fracture. Retrieval analysis suggested fatigue fracture as the likely mechanism. At time of revision, necrotic bone was found at the medial plateau, which likely caused cantilever bending relative to the well-supported portion of the tray and resultant failure. The patient continues to do well 5 years after revision TKA.
胫骨托骨折是全膝关节置换术（TKA）中一种罕见的并发症，主要发生在十多年前植入的假体中。本病例突出了一例当代假体中基板骨折的情况。该患者在TKA术后1年出现与鹅足滑囊炎相符的膝关节内侧疼痛。植入物 - 骨水泥 - 骨结构完整，她接受了皮质类固醇治疗。她持续疼痛，急性出现新的内翻畸形，并出现胫骨托骨折。取出分析表明疲劳骨折可能是其机制。翻修时，在内侧平台发现坏死骨，这可能导致相对于托盘支撑良好部分的悬臂弯曲并最终导致失败。该患者在TKA翻修术后5年情况良好。
