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The Journal of Bone and Joint Surgery 79:254-8 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Disengagement of a Locking Screw from a Modular Stem in Revision Total Knee Arthroplasty. A Report of Three Cases*

GEOFFREY H. WESTRICH, M.D.{dagger}, CHISA HIDAKA, M.D.{dagger} and RUSSELL E. WINDSOR, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at The Hospital for Special Surgery, Affiliated with The New York Hospital—Cornell University Medical Center, New York City


   Introduction
 
Use of modular components in either primary or revision total knee arthroplasty allows the surgeon to achieve intraoperative customization, optimum kinematics, and improved fixation1-8,11,13,15. Modularity in total knee arthroplasty includes augmentation of the femoral component with distal or posterior metallic blocks, or both, and augmentation of the tibial component with metallic wedges or blocks. In addition, fixation of the intramedullary stems is possible, and this allows stress relief and load-sharing with the host bone1,6-8,11,12. Although such elaborate configurations are unnecessary for most primary total knee arthroplasties, many surgeons routinely use intraoperative customization in revision procedures and frequently this customization involves the stem1,2,4-8,12,14.

Concerns with respect to modularity in total knee arthroplasty have arisen because of the many junctions of modular components. Issues relating to metallic wear, fretting, and corrosion between the body of the prosthesis and the various modular components require the surgeon to understand the potential . . . [Full Text of this Article]


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