J Korean Fract Soc.  2019 Jan;32(1):52-55. 10.12671/jkfs.2019.32.1.52.

Cortical Perforation Misidentified with Medial Condylar Fracture of Femur in Total Knee Arthroplasty: Case Report

• Seo SS
• Moon SW

• KMID: 2432499
• DOI: http://doi.org/10.12671/jkfs.2019.32.1.52

Abstract

Intraoperative fracture in total knee arthroplasty (TKA) is a rare complication. However, when it happens, additional surgery to fix the fracture site is needed. Therefore, it is important to diagnose intraoperative fractures in TKA exactly. The authors experienced two cases of cortical perforation of medial femoral condyle misidentified as the fracture in TKA. Cortical perforation could be misdiagnosed as the fracture, which could lead to unnecessary surgery. This is the first report about cortical perforation in TKA. We report two cases of intraoperative cortical perforations and describe the radiological characteristics.

Keyword

Femur; Medial condyle; Cortical bone; Perforation; Arthroplasty; Replacement; Knee

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Femur*
Knee
Unnecessary Procedures

Figure

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  Fig. 1 Radiography and computed tomography (CT) scan images of cortical perforation. (A) Radiography after total knee arthroplasty shows a vertical line on medial femoral condyle. (B) Coronal CT image shows a distinct vertical line. (C) Sagittal CT image also shows a vertical line. (D) Axial CT image shows the line localized on the posteromedial cortex.

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  Fig. 2 (A) Intraoperative image shows pin perforation on medial femoral condyle (arrow). (B) Radiography after total knee arthroplasty shows a cortical disruption on medial femoral condyle. (C) Coronal computed tomography image shows a distinct vertical line.

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