An Early Periprosthetic Fracture of a Cementless Oxford Unicompartmental Knee Arthroplasty: Risk Factors and Mitigation Strategies.

Introduction The cementless Oxford partial knee arthroplasty is associated with low perioperative complications and good long-term survival rates. However, perioperative fractures remain a serious morbidity for patients. Case report This case report describes an early post-operative tibial periprosthetic fracture through the keel slot, which we believe may be contributed by the deep implant keel design and the presence of a narrow metaphysis in the Asian knee. The patient subsequently underwent a revision total knee replacement and fixation of the periprosthetic fracture. Conclusion This paper discusses the ways to identify patients at high risk of developing periprosthetic fractures and to minimize such occurrences, including adopting a modified tibial preparation, doing precise saw cuts, and considering a cemented tibial implant.