AXLE FRACTURE OF A KINEMATIC ROTATING HINGE TOTAL KNEE ARTHROPLASTY WITH ASSOCIATED TIBIAL COMPONENT LOOSENING

Use of fully constrained total knee replacement is associated with hig h stresses within the implant, cement, and bone-cement interface. Symp tomatic joint instability and pain usually occur either when the prost hesis breaks or when the cement bond fails, resulting in loosening. We have treated an 83-year-old man who developed an unusual failure mech anism of a kinematic rotating hinge total knee arthroplasty involving both axle fracture and tibial component loosening. This was successful ly revised to an uncemented constrained implant utilizing long intrame dullary femoral and tibial stems. Use of long, press fit intramedullar y stems may permit use of prostheses with moderately constrained femor otibial articulations without the need for polymethylmethacrylate.