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Introduction: The use of modular implants for revision TKA are ever increasing in number due to their definitive advantage over their monoblock counterparts by providing the surgeon with the versatility needed to achieve equal gaps and manage bone defects. This superiority comes at the cost of certain unique complications attributable to its modular design such as loosening and fractures at the areas of component coupling that are prone to fatigue failure with suboptimal fixation.
Case Report: We present a case of modular femoral component failure in a 59-year man of Asian decent after revision TKA secondary to disengagement and migration of the extension stem locking bolt of a Total Condylar-III prosthesis. Patient presented with pain, effusion, and instability 2.5 years after stage-2 revision TKA. Radiographs revealed migration of the femur-stem locking bolt into the joint cavity. The femoral component and stem were loose. The locking bolt was extracted, and he underwent re-revision surgery with revised femoral components.
Conclusion: Stem-condylar junction of modern modular TKA implants are prone to early loosening and failure. This diagnosis should be anticipated on serial follow-up radiographs and in patients who complain of sudden onset of instability following revision surgery.
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http://dx.doi.org/10.13107/jocr.2022.v12.i12.3450 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopedic Surgery, Martini Hospital Groningen, Groningen, the Netherlands.
Purpose: Total knee arthroplasty (TKA) following an osteotomy around the knee might be technically more challenging and yield inferior outcome compared with primary TKA. The aim of this study was to investigate the survival, use of revision components and clinical outcome of TKAs postosteotomy compared with primary TKAs.
Methods: Patients from the Dutch Arthroplasty Register who underwent TKA after osteotomy or primary TKA with osteoarthritis as primary diagnosis from 2007 to 2022 and aged ≥18 years at the time of the procedure were selected.
Orthop Rev (Pavia)
September 2025
Introduction/background: Complex articular fractures around the knee in the elderly patient present an ongoing challenge regarding optimal treatment. While extensive research has evaluated immediate arthroplasty following fracture of the proximal femur, distal femur, proximal humerus, and elbow, relatively little focus has been given to immediate arthroplasty following complex tibia plateau fractures.
Methods: As seen with many other fractures, arthroplasty can shorten recovery and hospital stay and allow early weight-bearing with improved mobility while minimizing complications and possible future conversion arthroplasty cost.
J Exp Orthop
July 2025
Department of Orthopaedic Surgery Hôpital Pierre Paul Riquet, CHU de Toulouse Toulouse France.
Purpose: The aim of this study was to compare implant survival, clinical outcomes and radiographic alignment between navigated and non-navigated total knee arthroplasty (TKA) performed with a single implant system.
Methods: A retrospective multicenter analysis of prospectively collected data from 6078 TKAs performed for primary osteoarthritis using a single implant system was performed. Procedures were divided into two groups: navigated ( = 3602) and non-navigated ( = 2476).
J Arthroplasty
September 2025
Virginia Commonwealth University Health System, Department of Orthopaedic Surgery, 1200 E Broad St, Richmond, VA, 23298, USA.
Introduction: Obesity is an increasingly prevalent comorbidity that confers greater risks of postoperative complications following total joint arthroplasty, underscoring the need for viable preoperative weight loss. The objective of this study was to compare the risk of 90-day adverse events in patients undergoing total knee arthroplasty (TKA) following bariatric surgery versus treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA).
Methods: A retrospective review of a national research network from May 1, 2005, to February 12, 2025, identified patients undergoing TKA with bariatric surgery or GLP-1 RA prescriptions in the 18 months preceding their joint arthroplasty.
J Arthroplasty
September 2025
Implant Research Core, School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, PA, USA.
Background: In a subset of total hip arthroplasty (THA) patients, investigators associate metal release with biological complications. Comparatively, metal release in the knee is less understood. In this study, we systematically reviewed total knee arthroplasty (TKA) metal release studies.
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