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Related Experiment Videos

Screw osteolysis after cementless total knee replacement

P L Lewis1, C H Rorabeck, R B Bourne

  • 1Wakefield Orthopaedic Clinic, Adelaide, S. Australia.

Clinical Orthopaedics and Related Research
|December 1, 1995
PubMed
Summary
This summary is machine-generated.

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Radiographic changes at the screw-bone interface were evaluated in 217 cementless total knee replacements. The Anatomic Modular Knee (AMK) prosthesis showed a higher incidence of osteolysis, potentially linked to polyethylene debris and component design.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Cementless total knee replacements (TKR) are widely used.
  • Assessing long-term implant survival and potential complications like osteolysis is crucial.
  • Radiographic evaluation of the screw-bone interface is key to understanding implant fixation and loosening.

Purpose of the Study:

  • To compare radiographic changes at the screw-bone interface in three different cementless total knee prostheses.
  • To investigate the incidence and characteristics of lucency and osteolysis around screws.
  • To explore potential factors influencing these radiographic changes.

Main Methods:

  • A comparative radiographic review of 217 cementless total knee replacements (Miller Galante I, Miller Galante II, Anatomic Modular Knee) was performed 4 years post-surgery.

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  • Radiographic changes at the screw-bone interface were classified based on lucency width.
  • The incidence of cavitary and cystic changes was specifically analyzed for each prosthesis type.

    • Main Results:

    • Out of 851 screws studied, 265 (31.1%) showed some evidence of change.
    • 185 screws (21.7%) exhibited cavitary appearance changes.
    • The Anatomic Modular Knee (AMK) prosthesis demonstrated a significantly higher incidence of cystic and cavitary changes compared to Miller Galante designs.

    Conclusions:

    • The Anatomic Modular Knee prosthesis is associated with a higher rate of osteolysis at the screw-bone interface.
    • Polyethylene debris is implicated as a potential cause of osteolysis and radiographic changes.
    • Component design, particularly polyethylene attachment mechanisms, may influence the frequency of osteolysis in cementless total knee replacements.