Osteolysis around cementless porous-coated anatomic knee prostheses

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Cementless knee arthroplasty is a common procedure for treating knee joint diseases.
• Porous-Coated Anatomic prostheses are designed for biological fixation.
• Osteolysis, or bone loss, is a potential complication following joint replacement surgery.

Purpose of the Study:

• To investigate the incidence and patterns of osteolysis after cementless knee arthroplasty.
• To evaluate the long-term outcomes of Porous-Coated Anatomic prostheses.
• To identify factors contributing to osteolysis in knee replacement.

Main Methods:

• Prospective study of 44 patients (60 knees) undergoing cementless knee arthroplasty.
• Follow-up exceeding seven years with radiographic assessment.
• Analysis of component fixation, polyethylene wear, and osteolysis incidence.

Main Results:

• High incidence of osteolysis observed: 90% on tibial plateaux and 80% on intact patellar components.
• No femoral or tibial component loosening; 30 patellar components were loose (6 revised).
• Significant polyethylene liner wear (average 2.5 mm medial, 1.7 mm lateral); 6.7% revised for liner wear.

Conclusions:

• Cementless fixation of tibial and patellar components allows polyethylene debris migration, leading to significant osteolysis.
• The porous-coated anatomic prosthesis design may contribute to osteolysis due to interface issues.
• Further research is needed to mitigate osteolysis in cementless knee arthroplasty.