Evaluating the progression of osteolysis after total knee arthroplasty

Publication Date

2015

Journal Title

J Am Acad Orthop Surg

Abstract

Osteolysis around the knee following total knee arthroplasty continues to be a leading cause for revision total knee arthroplasty. Risk factors for periprosthetic knee osteolysis are associated with excessive polyethylene wear and include, but may not be limited to, malalignment of the mechanical axis, early-generation polyethylene sterilization techniques, excessive backside polyethylene wear, metal-backed patellar components, patient age, and an elevated body mass index. The initial diagnosis of osteolysis is frequently discovered on routine surveillance radiographs. The location, size, progressive nature, and associated symptomatology of the defect guides treatment. Surgical indications and timing are predicated on the risk of failure with continued observation. Advanced imaging helps to quantitate the size and location of osteolytic lesions as accurately as possible and aids in preoperative planning. When deciding whether surgery or management with continued radiographic surveillance is indicated, a global assessment of the character and progression of the osteolysis must be weighed with the risk factors associated with the patient.

Volume Number

23

Issue Number

3

Pages

173-80

Document Type

Article

EPub Date

2015/02/11

Status

Faculty

Facility

School of Medicine

Primary Department

Orthopedic Surgery

PMID

25667403

DOI

10.5435/jaaos-d-13-00189

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