A rare case of bilateral large osteolysis following cemented and cementless total knee arthroplasties

Dexel, Julian; Kirschner, S.; Harman, Melinda K.; Lützner, Jörg

doi:10.3109/17453674.2013.752693

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…However, considering that radiographs tend to underestimate the degree of osteolysis, it is challenging to assign a clear magnitude of the disease treated [ 29 ]. It is recognized that the use of CT or MRI provides some benefit for gaining a three-dimensional perspective of the lytic defect, as recently demonstrated by others [ 30 , 31 ]. MRI has been shown to be more accurate and sensitive than CT for defect detection in the femur, while CT performs with better accuracy in the tibia and in defects less than 2 cm 3 [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

Treatment for Wear and Osteolysis in Well-Fixed Uncemented TKR

et al. 2013

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Background. Traditionally, osteolysis around total knee replacements (TKRs) is treated with complete revision. In certain subsets, polyethylene insert exchange and bone grafting may be applicable. This study reports the clinical outcomes for selective bone grafting in patients with osteolysis without complete revision of the TKR. Methods. This retrospective study analyzes 10 TKRs (9 patients, 66.5 ± 6.1 years old) presenting with osteolysis and revised after 8.7 ± 1.9 years of in vivo function. At index TKR, all patients were implanted with uncemented prosthesis and modular polyethylene insert with anteroposterior articular constraint (Ultracongruent, Natural Knee II, Sulzer Medica). The surgical technique for treating the osteolysis included removal of necrotic bone tissue using curettage, filling of the defect with bone graft materials, and polyethylene insert exchange. Results. Patients have not exhibited any further complications associated with osteolysis after 5.1 ± 2.4 years of followup. Routine radiographic exams show total incorporation of the graft material into the previously lytic regions in all patients. Conclusion. In some TKRs with osteolysis and firmly fixed components, the removal of lytic tissue and subsequent defect filling with bone graft materials can be a viable solution. This case series shows complete resolution of osteolysis in all patients with no complications.

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Section: Resultsmentioning

confidence: 99%

Treatment for Wear and Osteolysis in Well-Fixed Uncemented TKR

et al. 2013

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Nonoperative Treatment of a Pathologic Proximal Tibia Fracture in the Setting of Previous Total Knee Arthroplasty

Carender

Wynn

Otero

et al. 2020

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Case: We present the case of a super obese 51-year-old woman with a pathologic fracture of the proximal tibia in the setting of a previous total knee arthroplasty. Imaging demonstrated an osteolytic lesion distal to the keel and pathologic fracture of the proximal tibia. Nonoperative treatment with a 12-week course of nonweight-bearing resulted in fracture healing and ossification of osteolysis. Conclusion: Pathologic fractures of the tibia secondary to osteolysis are frequently treated surgically. Patients may benefit from nonoperative management, even in the setting of super morbid obesity and significant osteolysis about the tibial component.

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A rare case of bilateral large osteolysis following cemented and cementless total knee arthroplasties

Cited by 2 publications

References 27 publications

Treatment for Wear and Osteolysis in Well-Fixed Uncemented TKR

Treatment for Wear and Osteolysis in Well-Fixed Uncemented TKR

Nonoperative Treatment of a Pathologic Proximal Tibia Fracture in the Setting of Previous Total Knee Arthroplasty

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