Ceramic femoral component fracture in total knee arthroplasty: an analysis using fractography, fourier-transform infrared microscopy, contact radiography and histology

The Journal of Arthroplasty
Alexander P KruegerChristoph H Lohmann

Abstract

Ceramic components in total knee arthroplasty (TKA) are evolving. We analyze the first case of BIOLOX delta ceramic femoral component fracture. A longitudinal midline fracture in the patellar groove was present, with an intact cement mantle and no bony defects. Fractographic analysis with laser scanning microscopy and white light interferometry showed no evidence of arrest lines, hackles, wake hackles, material flaws, fatigue or crack propagation. Analysis of periprosthetic tissues with Fourier-transform infrared (FT-IR) microscopy, contact radiography, histology, and subsequent digestion and high-speed centrifugation did not show ceramic debris. A macrophage-dominated response was present around polyethylene debris. We conclude that ceramic femoral component failure in this case was related to a traumatic event. Further research is needed to determine the suitability of ceramic components in TKA.

References

Apr 2, 2002·Biomaterials·Günther HeimkeGerd Willmann
Jun 10, 2004·The Journal of Arthroplasty·William L WalterMichael A Tuke
Jan 8, 2005·The Journal of Bone and Joint Surgery. American Volume·Hans-Georg WillertChristoph H Lohmann
Apr 6, 2006·The Journal of Bone and Joint Surgery. American Volume·Youn-Soo ParkSeung-Jae Lim
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Aug 5, 2014·JBJS Reviews·Antonia F Chen, Javad Parvizi

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Citations

Feb 10, 2016·Journal of Orthopaedic Surgery and Research·E MeierA Mauerer
Nov 7, 2017·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Lennert de RuiterNico Verdonschot
Apr 10, 2021·Der Orthopäde·Christian EgloffThomas Tischer

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