Search

Background: Mobile bearing fracture is a rare long‐term complication of unicompartmental knee arthroplasty (UKA), and relevant reports are sparse. Hence, its treatment options need further exploration. Case Presentation: This study presents the case of fracture of a polyethylene insert that occurred 12 years after mobile bearing medial UKA in a 75‐year‐old overweight woman who then underwent surgical intervention at our institution. However, we encountered significant challenges in removing the fragments from the broken bearing, resulting in retention of the remaining one‐third of the fragment. We solved this problem by replacing the fractured insert with thicker mobile bearing. During the 1‐month postoperative follow‐up, the patient achieved good range of motion and excellent satisfaction, with no reported complications and a Knee Society Score of 90. Additionally, we reviewed the literature on the treatment for mobile bearing fractures after UKA. Conclusions: Bearing fracture is a rare cause of failure of mobile bearing UKA. This case highlights the challenges of UKA fracture bearing retrieval and underscores that mobile bearing replacement can be an effective intervention. The case we report shows that when removal of a residual meniscal bearing in a posterior dislocation is difficult to achieve, compromise may be an appropriate option because it does not cause additional complaints to the patient. This case emphasizes the importance of the surgeon having a thorough preoperative understanding of the location and potential pitfalls of fracture fragments in such situations. [ABSTRACT FROM AUTHOR]

Objective: Total hip arthroplasty (THA) combined with proximal femoral reconstruction is a novel osteotomy technique developed to address severe hip deformities. There is a paucity of robust clinical and radiological evidence regarding the outcomes of this novel osteotomy technique. This study aimed to evaluate the clinical and radiological outcomes of THA combined with proximal femoral reconstruction during the early follow‐up. Methods: This is a retrospective case series of 63 hips who underwent THA combined with proximal femoral reconstruction at a single institution between January 2020 and July 2023. The mean age of patients was 39.6 ± 12.6 years. The mean follow‐up was 25.6 ± 3.8 months. Surgical characteristics and perioperative variables were evaluated to assess the efficacy of this technique. Harris hip score (HHS) was utilized to evaluate hip function. Leg length discrepancy (LLD) was evaluated in X‐ray. The incidence of major adverse events including deep vein thrombosis (DVT), osteolysis, nonunion of the osteotomy, intraoperative femoral fracture, and infection was also evaluated. Paired‐samples t‐test was used to compare preoperative and postoperative HHS and LLD. Results: The mean operative time was 125.1 min. The mean size of the acetabular components used was 45.2 mm, and the stem size was 7.5. The primary friction interface was ceramic‐on‐ceramic, accounting for 92.1% of cases. The average length of hospital stay was 8.5 days. The mean cost of treatment was 46,296.0 Yuan. There was a significant improvement in postoperative HHS (p < 0.001) and LLD (p < 0.001) compared to preoperative values. The incidence of deep venous thrombosis was 4.8%; osteolysis rates for the cup and stem were 4.8% and 6.4%, respectively. The non‐union and dislocation rates were 1.6% and 3.2%, respectively. There was no incidence of postoperative infection. Conclusion: The novel osteotomy surgical procedure yields reliable and impressive clinical and radiological outcomes, with minimal complications. We advocate for its use in complex primary THA cases involving severe proximal femoral deformities. [ABSTRACT FROM AUTHOR]