Evaluation of Periprosthetic Lucency After Total Ankle Arthroplasty: Helical CT Versus Conventional Radiography

Abstract

CT is a more accurate method for early detection and quantification of periprosthetic lucency than plain radiographs. Accurate evaluation of lucent lesions may identify patients at high risk for lack of syndesmotic fusion with subsequent loosening and implant failure.

Computed Tomography of Osteolysis Related to Total Ankle Replacement

“…More lesions were detected on CT than on radiographs. The mean size of the lesions on CT was over three times larger than the size on radiographs (Hanna et al, 2007). Few studies have been published concerning CT of osteolysis related to AES prosthesis (Besse et al, 2009;Rodriquez et al, 2009).…”

“…The scanned area should cover the whole implant, starting proximal to the tibial component and ending distal to the talar component. In some studies (Hanna et al, 2007;Puri et al, 2002) high kilovoltage (140 kVp) has been used to reduce implantrelated artifacts. However, it has also been estimated that there is no additional value attained in using settings more than 120 kVp (Lee et al, 2007).…”

“…Coronal, sagittal and axial images are routinely reformatted from the original data with 2 to 3 mm slice thickness. On CT osteolytic lesions have been defined as well demarcated, periprosthetic lucencies without detectable osseus trabeculae (Hanna et al, 2007). Figures 3 -6 show examples of TAR implants on CT. Fig.…”

“…4.2 Reported appearance of osteolysis on CT To our knowledge, the first study of total ankle replacement associated osteolysis and CT is where Hanna et al (2007) studied 17 patients (19 ankles). The implant used in the study was Agility Ankle implant (DePuy, Warsaw, IN) the only second generation prosthesis fully approved by the FDA at that time.…”

“…Periprosthetic osteolysis and aseptic loosening are common complications after TAR (Berquist, 2006;Besse et al, 2009;Koivu et al, 2009;Kokkonen et al, 2011;Rodriguez et al, 2010). CT reveals osteolytic changes around prosthesis components in ankle better than radiographs (Besse et al, 2009;Hanna et al, 2007;Koivu et al, 2009;Rodriguez et al, 2009). CT may also be useful in other total ankle replacement related conditions, e.g.…”