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Published on: June 6, 2025
Pin track induced fractures around computer-assisted TKA
J Beldame1, P Boisrenoult, P Beaufils
1Department of Orthopaedic Surgery and Traumatology, Hospital Center, 177, rue de Versailles, 78150 Le Chesnay, France.
Summary
Femoral fractures at navigation tracker pin sites occurred in 1.3% of computer-assisted total knee arthroplasties. Suboptimal pin placement and transcortical fixation in obese patients with thigh pain are risk factors.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Computer-assisted total knee arthroplasty (TKA) requires rigidly fixed navigation tracker pins.
- Fractures at navigation tracker pin sites are a newly reported complication.
Purpose of the Study:
- To investigate demographic and radiological factors contributing to femoral fractures at navigation tracker pin sites.
- To identify risk factors and circumstances associated with this complication.
Main Methods:
- Retrospective analysis of 385 total knee arthroplasties.
- Investigation of five patients who sustained femoral fractures at the tracker pin site.
- Analysis of demographic data (BMI) and radiological factors (pin placement).
Main Results:
- An incidence of 1.3% for fractures at the navigation tracker pin site was observed.
- Fractures occurred 7-21 weeks post-arthroplasty, often preceded by thigh pain and minor trauma.
- Suboptimal pin placement (diaphyseal femur, transcortical fixation) was noted in most cases.
Conclusions:
- Fractures at navigation tracker pin sites are a significant complication with a 1.3% incidence.
- Risk factors include obesity, thigh pain preceding fracture, diaphyseal pin placement, and transcortical fixation.
- Bicortical metaphyseal fixation is recommended to minimize fracture risk.