Pubic ramus fatigue fractures after total knee arthroplasty. A case report

Fatigue fractures in the rheumatoid population are infrequent but well described clinical and radiographic entities, and rarely occur within the pelvis. These fractures often are difficult to diagnose. Pelvic fatigue fractures are much less commonly detected and reported after total joint arthroplasties. This article reports the sequential appearance of fatigue fractures of the superior portions of both pubic rami after total knee replacement arthroplasties which were not suspected on historical review, physical examination, nor well visualized on initial plain radiographs and technetium bone scanning.