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Related Experiment Videos

Osteolysis after total knee arthroplasty without cement.

P C Peters1, G A Engh, K A Dwyer

  • 1Anderson Orthopaedic Research Institute, Arlington, Virginia 22206.

The Journal of Bone and Joint Surgery. American Volume
|July 11, 1992
PubMed
Summary

Osteolysis, or bone loss, is a complication of cementless total knee replacement. This study found osteolysis in 16% of implants, often requiring revision surgery due to wear debris and component failure.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Pathology

Background:

  • Osteolysis is a significant concern in total knee arthroplasty (TKA).
  • Cementless fixation is a common method for TKA, but its long-term effects require investigation.

Purpose of the Study:

  • To determine the prevalence and characteristics of osteolysis following cementless total knee arthroplasty.
  • To investigate the factors contributing to osteolysis in these implants.

Main Methods:

  • Retrospective analysis of 174 consecutive cementless TKAs.
  • Radiographic and intraoperative assessment of osteolysis.
  • Histological evaluation of tissue from revision surgeries.
  • Analysis of wear debris and component failure modes.

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Main Results:

  • Osteolysis was identified in 16% of implants (26 patients) at an average of 35 months post-operation.
  • 56% of affected prostheses required revision surgery.
  • Histology revealed polyethylene and metal wear debris, with sizes up to 3 micrometers.
  • Contributing factors included polyethylene insert failure, polyethylene tibial eminence abrasion, patellar component failure, and screw-baseplate corrosion.

Conclusions:

  • Osteolysis is a demonstrable complication associated with cementless total knee replacement.
  • Wear debris from various implant components and material corrosion are key contributors to osteolysis.
  • Understanding these mechanisms is crucial for improving the longevity of cementless TKAs.