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Clinical Orthopaedics and Related Research®

, Volume 469, Issue 6, pp 1709–1715 | Cite as

How to Treat A Tibial Post Fracture in Total Knee Arthroplasty?

A Systematic Review
  • Paul F. LachiewiczEmail author
Survey

Abstract

Background

Posterior-stabilized TKAs, which use a polyethylene tibial post to articulate against a metal femoral cam, are used regularly. Reported complications are related to the patellofemoral articulation or the tibial post-cam mechanism. Fracture of the tibial post is an uncommon but disabling complication after posterior-stabilized TKA that requires operative treatment.

Questions/purposes

The literature was reviewed to determine the frequency of tibial post fracture and address three questions: (1) Is there a specific prosthetic design or patient demographics in knees with a fracture of the tibial post? (2) What are the common presenting complaints and methods of diagnosis? (3) What methods of treatment have been used?

Methods

A PubMed search of English language articles from February 1982 to April 2010 was performed and 20 articles, all Level IV studies, were identified.

Results

One specific design of posterior-stabilized tibial post with a central screw hole had a 12.4% incidence of fracture. Tibial post fracture has been reported with other designs, but with an incidence of 1% or less. The most common presenting symptoms include effusion, instability, or patella clunk syndrome. The most common method of diagnosis was clinical examination followed by arthroscopic examination. Treatment with revision to a new tibial polyethylene liner generally has been successful at short-term followup.

Conclusions

Tibial post fracture is a relatively uncommon complication after posterior-stabilized TKA that usually is treated successfully with liner exchange. The low quality of available literature makes it difficult to recommend a specific treatment protocol.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Total Knee Arthroplasty Tibial Component Tibial Tray Tibial Post Common Present Complaint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

I thank Stephen Pearlman for help with the literature search.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  1. 1.Department of SurgeryDurham VA Medical CenterDurhamUSA
  2. 2.Department of Orthopaedic SurgeryDuke UniversityDurhamUSA
  3. 3.Chapel Hill Orthopedics Surgery and Sports MedicineChapel HillUSA

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