{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:53:51Z","timestamp":1792500831112,"version":"4.5.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 66-year-old active man had undergone revision total knee replacement surgery with a femoral metaphyseal sleeve and a cemented stem in 2013 after loosening of the implant following the primary knee arthroplasty. He was overweight and had a high activity level, and there had been progressive osteolysis surrounding the distal aspect of the femoral sleeve. In 2017, the metaphyseal sleeve had loosened, resulting in corrosion of the threaded taper and catastrophic failure of the implant, with a fracture of the stem at the junction of the sleeve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This unique method of failure in this knee implant highlights a weak point in the design. Clinicians must be aware of the increased likelihood of this type of failure with these implants in patients who have contributory factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.17.00320","type":"journal-article","created":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T15:32:31Z","timestamp":1534865551000},"page":"e67-e67","source":"Crossref","is-referenced-by-count":4,"title":["Failure and Fatigue Fracture at the Femoral Stem-Metaphyseal Sleeve Junction in a Modular Knee Prosthesis"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-5868","authenticated-orcid":false,"given":"Tom","family":"Christiner","sequence":"first","affiliation":[{"name":"Department of Medical Engineering and Physics, Centre for Implant Technology and Retrieval Analysis, Royal Perth Hospital, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4223-0416","authenticated-orcid":false,"given":"Moreica B.","family":"Pabbruwe","sequence":"additional","affiliation":[{"name":"Department of Medical Engineering and Physics, Centre for Implant Technology and Retrieval Analysis, Royal Perth Hospital, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3794-9821","authenticated-orcid":false,"given":"Markus","family":"Kuster","sequence":"additional","affiliation":[{"name":"Perth Orthopaedic and Sports Medicine Centre, West Perth, Western Australia, Australia"},{"name":"The University of Western Australia, Crawley, Western Australia, Australia"},{"name":"Curtin University, Bentley, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,9]]},"reference":[{"issue":"2","key":"bib1-20230811","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00264-013-2262-1","article-title":"Bone loss management in total knee revision surgery","volume":"38","author":"Panegrossi","year":"2014","journal-title":"Int Orthop."},{"issue":"2","key":"bib2-20230811","first-page":"75","article-title":"Implant designs in revision total knee arthroplasty","volume":"45","author":"Elmallah","year":"2016","journal-title":"Am J Orthop (Belle Mead NJ)."},{"key":"bib3-20230811","first-page":"167","article-title":"Bone loss with revision total knee arthroplasty: defect classification and alternatives for reconstruction","volume":"48","author":"Engh","year":"1999","journal-title":"Instr Course Lect."},{"issue":"12","key":"bib4-20230811","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1302\/0301-620X.95B12.31190","article-title":"Metal metaphyseal sleeves in revision total knee replacement","volume":"95-B","author":"Agarwal","year":"2013","journal-title":"Bone Joint J."},{"issue":"8","key":"bib5-20230811","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1002\/jor.22894","article-title":"The role of complex clinical scenarios in the failure of modular components following revision total knee arthroplasty: A finite element study","volume":"33","author":"Conlisk","year":"2015","journal-title":"J Orthop Res."},{"issue":"2","key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"254","DOI":"10.2106\/00004623-199702000-00015","article-title":"Disengagement of a locking screw from a modular stem in revision total knee arthroplasty. 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