A case of a fractured polyethylene stabilizing insert causing secondary knee instability in a Dual-articular total knee arthroplasty (TKA) is presented. A 65-year-old woman who underwent surgery with a Dual-articular TKA 4 years earlier had a well-functioning prosthesis until a fall, after which she began complaining of an intermittent, audible clicking; pain; and instability. At surgery, a fractured polyethylene peg was discovered, and the tibial insert was replaced. At follow-up, she remains asymptomatic. This is the first description of a fractured stabilizing insert in a Dual-articular knee.

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