Fatigue failure of the femoral component of a unicompartmental knee.

A unicompartmental knee implant was retrieved after 11 years in situ. The cast stainless steel femoral component had fractured approximately 1 cm from the anterior tip. The implant and clinical tolerance were analyzed to ascertain the factors associated with the mechanical failure. Increased tensile stresses owing to poor surgical placement and wear on the weight-bearing surface of the component, together with the quality of implant material, influenced the mechanical failure. Examination of the fracture surface revealed fatigue to be the mode of failure. Microscopic analysis of sections through the specimens showed a high inclusion content and inhomogeneous grain size, typical of the cast stainless steel from which the femoral component was fabricated.