Case: The usual mechanism of failure of a total knee arthroplasty is aseptic loosening of the tibial component. We present a case of an atraumatic late failure by fracture of the femoral component in an active 83-year-old and review the very small number of similar cases within the literature.
Conclusion: Although it is difficult to draw firm conclusions on such a rare presentation, it appears the heavy-set, active man may be at risk of a femoral component fracture in the long-term. This case also raises an important question about diligence in cementing techniques for the femoral component.