Polyethylene Insert Wear Leading to Early Aseptic Bilateral Total Knee Arthroplasty Failure: Case Report

Component failure is one of the most dreaded complications of any total knee arthroplasty (TKA) surgery. To tackle this, implant technology continues to evolve with the goal of increasing implant survivorship post-TKA surgery. It is estimated that about 20% of TKA revisions are due to mechanical aseptic loosening. Polyethylene insert wear has become an increasingly common finding at the time of revision surgeries. With this case report, we try to highlight the challenges faced during bilateral revision TKA and the use of both femoral and tibial augments to compensate for the bony osteolysis.

A 69-year-old patient with unusual presentation of bilateral TKA (Exactech, Hiflex) failure 6 years post-surgery due to polyethylene wear. Three months following surgery, the patient had no complications and had satisfactory radiological, pain, and functional outcomes.

Although aseptic TKA failure due to polyethylene wear is an uncommon finding. Our case of the 69-year-old male with bilateral arthroplasty failure highlights the significance of the durability of polyethylene along with its wear and fracture resistance. It demonstrates that timely intervention with revision arthroplasty drastically improves pain, mobility, joint stability, and overall quality of life in these patients.