Tate Jackson P, Schneider Andrew M, Brown Nicholas M
Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center, Chicago, IL, USA.
Arthroplast Today. 2023 Jul 22;22:101174. doi: 10.1016/j.artd.2023.101174. eCollection 2023 Aug.
This article reports a rare case of a total knee arthroplasty femoral component fracture. Fractures of early knee systems were attributed to design flaws. Modern design failures have been attributed to poor surgical technique or underlying osteolysis. Here, we report a fracture in the Vanguard prosthesis (Zimmer Biomet, Warsaw, IN) 12 years after implantation in a patient with a persistent flexion contracture. The fracture likely occurred due to fatigue failure of the anterior flange secondary to increased stress from a high riding patella. Although femoral component fractures are rare, they should be considered as a potential complication, especially in patients with special load considerations. For these patients, it is essential that the prosthesis be properly supported with clean cuts and an adequate cement mantle.
本文报道了一例全膝关节置换术股骨部件骨折的罕见病例。早期膝关节系统的骨折归因于设计缺陷。现代设计失败则归因于手术技术不佳或潜在的骨溶解。在此，我们报告一例患者在植入Vanguard假体（捷迈邦美公司，印第安纳州华沙）12年后出现骨折，该患者存在持续性屈曲挛缩。骨折可能是由于高位髌骨导致应力增加，致使前凸缘发生疲劳失效。尽管股骨部件骨折罕见，但应将其视为一种潜在并发症，尤其是在有特殊负荷考虑的患者中。对于这些患者，至关重要的是要用干净的切口和足够的骨水泥套来妥善支撑假体。
