Fatigue Failure of Semiconstrained Total Knee Replacement: Magnetic Resonance Imaging Diagnosis With Tips and Tricks for Extraction and Reconstruction

Modular components allow for the precise adjustment of sizing and balancing in knee replacement and are widely used in revision total knee arthroplasty. While they have a significant advantage over monoblock implants, these components may be associated with fretting and corrosion at modular junctions. We report the case of a fracture of a morse taper adapter bolt in a 65-year-old female with a history of multiple revision knee arthroplasties. Only a few cases of fracture of the taper adapter bolt have been previously reported. We reinforce 2 learning points in this report: the utility of magnetic resonance imaging as an aid in diagnosing total knee failure when initial radiographs are unremarkable and the use of techniques such as anterior quadrangular femoral osteotomy when an implant is unable to be removed via conventional techniques.