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Tibial Osteolysis After Long-Term Isolated Polyethylene Patellar Resurfacing
Andrew E Apple1, Corey O Montgomery1, Simon C Mears1
1Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Arthroplasty Today
|May 3, 2021
Summary
Isolated patellar resurfacing can lead to rare tibial osteolysis due to polyethylene wear particles. This case highlights a 20-year complication of tibial bone loss following this early knee arthritis treatment.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Isolated patellar resurfacing was an early treatment for patellofemoral arthritis.
- This procedure was largely abandoned due to concerns about femoral trochlear groove erosion.
Observation:
- A patient developed a large tibial osteolytic lesion 20 years after isolated patellar resurfacing.
- The polyethylene patellar component was significantly worn, generating debris.
Findings:
- The wear debris from the worn patellar component caused a cavitary lesion in the proximal tibia.
- This represents a rare complication of osteolysis in patellofemoral arthroplasty.
- This is the first reported case of native tibial osteolysis following isolated patellar resurfacing.
Implications:
- This case underscores the long-term risks associated with polyethylene wear in patellofemoral joint replacements.
- Management involved curettage, bone grafting, and subsequent total knee arthroplasty with specialized fixation.
- Highlights the importance of considering wear debris in long-term implant survival and bone integrity.
