Early failure of all polyethylene tibial components in bilateral total knee arthroplasty: A case report

Abstract

Introduction: Outcomes of Total Knee Arthroplasty (TKA) performed with modern all polyethylene (AP) tibial components have been reported to be comparable with or better than those TKAs performed using metal-backed modular (MBM) tibial components in several medium and long term studies. As AP components also provide substantial cost savings, there has been increase in their use in primary TKA. In spite of such good results, failure of AP tibial components has been reported.Case Presentation: A sixty three year old lady operated for bilateral cruciate retaining PFC Sigma TKA utilizing AP tibial components without patellar resurfacing in 2011 presented to us in December 2014 with two-year history of severe pain in both knees and inability to walk or stand. She had marked varus deformity of both knees. Radiological examination revealed fracture of the medial tibial plateau with failure of AP tibial component and marked varus deformity. She was treated with bilateral staged revision TKA which resulted in a satisfactory outcome. Conclusion: This case report describes previously unreported complication of AP tibial component following cruciate retaining bilateral AP tibia PFC Sigma TKA in a patient of varus osteoarthritis of knee joint. Early collapse of medial tibial plateau leading to failure of bilateral TKA, which could be attributed to under correction of varus deformity and instability, was managed with bilateral revision TKA using tibial metaphyseal sleeves which led to a very satisfactory outcome and excellent five year follow up.