Periprosthetic tibial fracture with extraosseous cement

Case contributed by Henry Knipe
Diagnosis certain


Disproportionate pain post right total knee joint revision.

Patient Data

Age: 60 years
Gender: Female

Long stemmed femoral and tibial component total knee replacement. Extraosseous cement is seen along the medial tibial cortex but no discrete fracture line is seen. 

Right total knee joint revision with long-stem femoral and tibial components. Periprosthetic fracture of the anteromedial tibial shaft with a small comminuted bone fragment superiorly and vertical extension. Associated small volume of extraosseous cement.

Case Discussion

Intraoperative fracture during total knee replacements is uncommon, with one series 1 reporting a rate of 0.7%. In this case, the extraosseous cement is the primary sign of a fracture, which is easily seen on CT. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.