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Rotating Hinge Distal Femur Replacement: A Turn for the Worse

Bryce N Clinger1, Kathryn C Helmig1, Scott Plaster1

  • 1Department of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
|February 21, 2022
PubMed

Insights

Periprosthetic joint infection can lead to rare but serious complications, such as 180° rotation of press-fit femoral components after surgery. Awareness of this risk is crucial for orthopedic surgeons performing joint replacement procedures.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Periprosthetic joint infection (PJI) is a significant complication following arthroplasty.
  • Press-fit femoral components are commonly used in modern joint replacement surgery.
  • Understanding potential failure modes of implants is critical for patient safety.

Observation:

  • A rare case of 180° rotation of a press-fit femoral component occurred postoperatively.
  • This complication was associated with a preoperative periprosthetic joint infection.
  • The rotational instability presented a unique challenge in revision arthroplasty.

Findings:

  • Preoperative infection can compromise the fixation of press-fit femoral components.
  • Significant rotational malalignment of the femoral component can occur as a direct consequence of infection.
  • This complication highlights the biomechanical vulnerability of press-fit designs in infected joints.

Implications:

  • Arthroplasty surgeons must be aware of the potential for femoral component rotation in infected cases.
  • Early recognition and management are essential to prevent further complications.
  • This case underscores the importance of robust implant fixation strategies, especially in the presence of infection.

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