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Arthroscopy for evaluation of polyethylene wear after total knee arthroplasty
Makoto Kondo1, Tadashi Fujii, Hiroshi Kitagawa
1Department of Orthopaedic Surgery, Kashiba Asahigaoka Hospital, 839 Kaminaka, Kashiba, Nara, 639-0265, Japan.
Background:
The purpose of this report is to demonstrate the severity of polyethylene wear by arthroscopy after total knee arthroplasty (TKA).
Methods:
Polyethylene wear of TKA prostheses was evaluated endoscopically in eight knees (six patients). Arthroscopy was indicated when the patients had persistent but slight hydroarthrosis and instability confirmed by stress radiography, but these findings were insufficient for a consensus on polyethylene revision. The average interval between primary TKA and arthroscopy was 9 years 3 months.
Results:
All knees had unexpectedly widespread, severe polyethylene wear characterized by delamination. Based on arthroscopic visualization of the damage to the polyethylene, all patients consented to undergo isolated polyethylene surface revision surgery. The severity of polyethylene wear was worse than anticipated at the evaluation arthroscopy. After a mean follow-up of 5 years 6 months, all knees were stable and symptom-free.
Conclusions:
The usefulness of arthroscopy is validated in certain groups of patients with polyethylene wear when diagnosed with careful clinical examination and stress radiography.