Tibial Stress Fracture After Computer-Navigated Total Knee Arthroplasty

Abstract

In this case report, the patient experienced a stress fracture at one of the pinhole sites used for placement of the computer navigation system’s tibial trackers. Introduction The use of computer navigation systems in total knee arthroplasty (TKA) has become increasingly popular in recent years. Many authors have already documented satisfactory short- to mid-term results after using various types of software [1-3].Bathis et al [4], as well as Decking et al [5] and Rosenberger et al [6], showed how the use of navigation systems can improve the accuracy of the femoral and tibial component placement when compared with the “traditional” techniques. Because a correct alignment of the components is one of the most important factors determining favorable long-term results of a TKA, this could lead to a higher longevity of the prosthesis.Despite these positive aspects, some authors have reported no advantages, as well as a longer operative time with the use of computer-assisted systems [7,8]. Moreover, recently three cases of stress femoral or tibial fractures have been reported as a complication of navigated TKA [9,10].We present a case of a stress fracture of the tibial diaphysis that occurred after a TKA performed with the use of a computer navigation system. The stress fracture occurred at one of the pinhole sites used for the placement of the tibial trackers.We have been using computer navigation systems since 2005 as a standard procedure for TKA. This complication occurred after a series of 155 (0.64%) uncomplicated procedures (ie, well after the learning curve was complete).