The incidence of implant fractures after knee arthroplasty
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This study aimed to evaluate the incidence of “implant” fractures after knee arthroplasty using clinical literature and worldwide arthroplasty registers. The hypothesis was that register datasets report higher rates of these rare complications than clinical studies.
Calculations were based on the pooled incidence of revision operations after fractures of knee arthroplasties, comparing clinical studies published in MEDLINE-listed journals and annual reports from worldwide arthroplasty registers in a structured literature analysis based on a standardized methodology.
Twelve clinical studies and datasets from six worldwide registers were included. Rates of fractures of knee arthroplasties were reported from 0.2 to 2.5 % in clinical studies versus 0.02–0.17 % in worldwide arthroplasty registers.
Fractures of knee arthroplasty systems are rare complications, with clinical studies showing higher incidence rates than worldwide arthroplasty registries. Unicompartmental knee arthroplasty (UKA) implanted before 2000, constrained primary or revision constrained total knee arthroplasties, and patellar replacements showed the highest incidence of implant fracture. The results of this analysis can help clinicians to counsel patients on potential complications following knee arthroplasty.
Level of evidence
KeywordsImplant Fracture Breakage Knee Arthroplasty TKA TKR Replacement
Body mass index
Observed component years
Quality of literature in arthroplasty
Total knee arthroplasty
Unicompartmental knee arthroplasty
MMG contributed to conception and design, acquisition of data, interpretation of data, and drafting of manuscript. CWZ contributed to conception and design, acquisition of data, and revising the manuscript. LL contributed to analysis and interpretation of data and revising the manuscript. AL contributed to interpretation of data and revising the manuscript. GL contributed to conception and design and analysis and interpretation of data. PS contributed to conception and design, interpretation of data, and revising the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
Each author certifies that he or she, or a member of their immediate family, has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Conflict of interests
The authors did not receive financial support for this study, and there are no known conflicts of interest associated with this publication that could have influenced its outcome.
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