Fatigue fracture of tibial arthroplasty implant masked by contralateral knee arthritis

INTRODUCTIONThe wear of polyethylene components is a well-recognised long-term complication of total knee arthroplasty.PRESENTATION OF CASEWe present a case of fatigue fracture of a geomedic tibial tray 17 years after implantation. The symptoms were masked by primary osteoarthritis of the contralateral knee.DISCUSSIONThe mode of failure in this case differs from that most commonly reported in the literature in that it occurred late as the result of prolonged use, not due to implant failure, physiological factors, or surgical technique. The case also demonstrates the incredible ‘masking’ effect of arthritic knee pain.CONCLUSIONThis case highlights the importance to clinicians of keeping a high index of suspicion for prosthesis complications in patients with unilateral joint replacement with contralateral arthropathy.