TY - JOUR
T1 - The Natural History of Radiolucencies Following Uncemented Total Knee Arthroplasty at 9 Years
AU - Costales, Timothy G.
AU - Chapman, Danielle M.
AU - Dalury, David F.
N1 - Funding Information:
Conflicts of Interest and Source of Funding: D.F.D. receives royalties for transfer of intellectual property and research support and serves as a consultant to Johnson and Johnson. There was no outside source of funding.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - Background: Aseptic loosening remains a common cause of failure in total knee arthroplasty (TKA). There is an increased interest in using uncemented TKA to reduce this complication. Radiolucencies (RLs) following uncemented TKA can be concerning. We report on the 9-year history of RLs in patients with uncemented TKA. Methods: Twenty-one patients (26 knees) were treated with a cruciate-retaining fully porous coated femur/tibia and cemented patella. At final follow-up, 17 patients (22 knees) were available for review. Average follow-up was 9.6 years, average age was 59.1, and average body mass index was 34.1. X-rays were taken at 6 weeks, 1 year, and at final follow-up. RLs were measured using the Knee Society scoring system and read by two separate surgeons. Results: At 6 weeks, we identified RL in all patients on both the tibia and femur. The majority were beneath the tibial tray and femoral chamfer. At 1 year, 4 femurs and 4 tibias showed new RLs (<2 mm) in similar zones. Eighteen femurs and 18 tibias showed fewer or no change in RLs. At final follow-up, no new tibia or femur developed a new RL. In total, 9 of the 22 tibias and 17 of the 22 femurs had remaining RLs, all less than 2 mm and none were progressive or new. Knee Society Score averaged 92.5 (6 weeks), 95.1 (1 year), and 97.3 (final). Conclusion: RLs are common following uncemented TKA. Many resolve by 1 year. There does not appear to be any association between the presence of RLs and long-term follow-up function in this group of patients.
AB - Background: Aseptic loosening remains a common cause of failure in total knee arthroplasty (TKA). There is an increased interest in using uncemented TKA to reduce this complication. Radiolucencies (RLs) following uncemented TKA can be concerning. We report on the 9-year history of RLs in patients with uncemented TKA. Methods: Twenty-one patients (26 knees) were treated with a cruciate-retaining fully porous coated femur/tibia and cemented patella. At final follow-up, 17 patients (22 knees) were available for review. Average follow-up was 9.6 years, average age was 59.1, and average body mass index was 34.1. X-rays were taken at 6 weeks, 1 year, and at final follow-up. RLs were measured using the Knee Society scoring system and read by two separate surgeons. Results: At 6 weeks, we identified RL in all patients on both the tibia and femur. The majority were beneath the tibial tray and femoral chamfer. At 1 year, 4 femurs and 4 tibias showed new RLs (<2 mm) in similar zones. Eighteen femurs and 18 tibias showed fewer or no change in RLs. At final follow-up, no new tibia or femur developed a new RL. In total, 9 of the 22 tibias and 17 of the 22 femurs had remaining RLs, all less than 2 mm and none were progressive or new. Knee Society Score averaged 92.5 (6 weeks), 95.1 (1 year), and 97.3 (final). Conclusion: RLs are common following uncemented TKA. Many resolve by 1 year. There does not appear to be any association between the presence of RLs and long-term follow-up function in this group of patients.
KW - aseptic loosening
KW - cementless TKA
KW - radiolucency
KW - total knee arthroplasty
KW - total knee replacement
KW - uncemented TKA
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U2 - 10.1016/j.arth.2019.08.032
DO - 10.1016/j.arth.2019.08.032
M3 - Article
C2 - 31537374
AN - SCOPUS:85072227357
SN - 0883-5403
VL - 35
SP - 127
EP - 131
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 1
ER -