Metal-backed patellar component failure in total knee arthroplasty presenting as a giant calf mass

Failure of total knee arthroplasty (TKA) caused by wear of the polyethylene-bearing surface of a metal-backed tibial platform or a metal-backed patellar component is a recognized complication. We present a case of a 78-year-old woman with a cystic mass in the left calf caused by metal wear debris from the failure of a Miller-Galante I TKA. The patient received a left TKA to treat advanced osteoarthritis in July 1990 and was lost to follow-up immediately after the operation. In December 1998, she presented at our clinic 2 days before admission, when an originally silent mass over the calf turned intolerably painful. A series of examinations revealed a calf mass caused by wear debris of total knee prosthesis and subsequent inflammation of the knee joint. Curettage of the cyst and simultaneous revision TKA were successful in relieving her symptoms.