Catastrophic Tibial Baseplate Fracture in the TC-PLUS™ Total Knee System: A Case Report and Literature Review

The number of patients having total knee arthroplasty (TKA) is advancing rapidly. The outcome of this rapid development is an increase in revision TKA (rTKA). A rare indication for rTKA is implant failure, most notably fracture of the tibial baseplate. The pathway leading to the fracture is based upon the theory of the cantilever effect between the supported and unsupported tray. This phenomenon can be a result of chronic osteolysis due to malalignment of implants and insufficient ligament balance, or in shorter postoperative time due to undersizing of the implants in combination with false placement, which leads to inadequate cortical support. This paper presents a case of tibial tray fracture occurring 17 years after primary TKA, managed with a hinged revision, along with a literature review of this rare complication.