Failure of the tibial insert in a rotating hinge total knee arthroplasty

There has been a steady increase in the number of revision total knee arthroplasties being performed in the United States. Hinge knee prostheses are used predominantly in complex primary or revision arthroplasties, often as salvage procedures. Significant improvement of the articulation between the rotating hinge mechanism and tibial component has decreased the stresses that contributed to earlier failures in previous generation designs. Two cases of fracture of the tibial metal post in the rotating hinge of a revision total knee arthroplasty were evaluated and treated at our institution within a 1-month period. We present our experience with this construct failure and subsequent patient management.