Presentation
Disproportionate pain post right total knee joint revision.
Patient Data
Age: 60 years
Gender: Female
From the case:
Periprosthetic tibial fracture with extraosseous cement
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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.
From the case:
Periprosthetic tibial fracture with extraosseous cement
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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.
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