Insufficiency Fracture of the Neck of the Talus After Total Knee Arthroplasty.

Abstract

Insufficiency fractures are rarely reported after total knee arthroplasty (TKA). A 79-year-old woman with osteoporosis underwent revision of a unicompartmental arthroplasty to TKA. Six weeks later, she developed ipsilateral ankle pain. Examination revealed lateral ankle tenderness with preserved motion; initial radiographs were normal. Worsening pain prompted an MRI, which uncovered an undisplaced talar neck insufficiency fracture. Conservative treatment with immobilization and protected weight bearing led to complete healing at 1 year. This is the first documented case of a talar neck insufficiency fracture after TKA. Surgeons should consider this rare diagnosis in patients with post-TKA ankle pain, particularly in osteoporotic women.