Periprosthetic osteolysis after AES total ankle replacement: Conventional radiography versus CT-scan

Viste, Anthony; Zahrani, Nader Al; Brito, Nuno; Lienhart, Christophe; Fessy, Michel Henri; Besse, Jean-Luc

doi:10.1016/j.fas.2014.11.002

Cited by 42 publications

(29 citation statements)

References 24 publications

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“… 2007 , Viste et al. 2015 ). CT also allows more accurate preoperative planning before revision surgery, especially regarding residual bone stock.…”

Section: Discussionmentioning

confidence: 98%

Ballooning osteolysis in 71 failed total ankle arthroplasties

et al. 2016

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Background and purposeAseptic loosening is a major cause of failure in total ankle arthroplasty (TAA). In contrast to other total joint replacements, large periarticular cysts (ballooning osteolysis) have frequently been observed in this context. We investigated periprosthetic tissue responses in failed TAA, and performed an element analysis of retrieved tissues in failed TAA.Patients and methodsThe study cohort consisted of 71 patients undergoing revision surgery for failed TAA, all with hydroxyapatite-coated implants. In addition, 5 patients undergoing primary TAA served as a control group. Radiologically, patients were classified into those with ballooning osteolysis and those without, according to defined criteria. Histomorphometric, immunohistochemical, and elemental analysis of tissues was performed. Von Kossa staining and digital microscopy was performed on all tissue samples.ResultsPatients without ballooning osteolysis showed a generally higher expression of lymphocytes, and CD3+, CD11c+, CD20+, and CD68+ cells in a perivascular distribution, compared to diffuse expression. The odds of having ballooning osteolysis was 300 times higher in patients with calcium content >0.5 mg/g in periprosthetic tissue than in patients with calcium content ≤0.5 mg/g (p < 0.001).InterpretationThere have been very few studies investigating the pathomechanisms of failed TAA and the cause-effect nature of ballooning osteolysis in this context. Our data suggest that the hydroxyapatite coating of the implant may be a contributory factor.

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“… 2007 , Viste et al. 2015 ). CT also allows more accurate preoperative planning before revision surgery, especially regarding residual bone stock.…”

Section: Discussionmentioning

confidence: 98%

Ballooning osteolysis in 71 failed total ankle arthroplasties

et al. 2016

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“…Four zones were defined on the tibial side. Each zone was classified as either normal, lucent or cystic loosening . Loosening of the talar component as seen on the lateral radiograph was defined as subsidence into the talus by >5 mm or change in position of >5° relative to a line drawn from the top of the talonavicular joint to the tuberosity of the calcaneus .…”

Section: Methodsmentioning

confidence: 99%

Total ankle replacement in patients with haemophilic arthropathy: primary arthroplasty and conversion of painful ankle arthrodesis to arthroplasty

et al. 2017

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“…We recommend annual followup with conventional imaging to evaluate for progressive change. In ankles in which the progression of radiolucency may be seen or suspected, we recommend performing CT for exact assessment of radiolucent lines [60]. Instability and/or subluxation is another possible reason for revision surgery in up to 9% of all TARs [54,55].…”

Section: Discussionmentioning

confidence: 99%

“…Four zones were defined on the tibial side. Each zone was classified as osseointegrated (visible trabeculae at the prosthesis-bone interface), or cystic loosening (cystic lesion with a diameter at least 2 mm) [60]. Loosening of the talar component, as seen on the lateral radiograph, was defined as subsidence in the talus by more than 5 mm or change in position greater than 5°relative to a line drawn from the top of the talonavicular joint to the tuberosity of the calcaneus [29,37].…”

Section: Methodsmentioning

confidence: 99%