Osteolysis in Cementless Total Knee Arthroplasty

Han, Chang Dong; Lee, Woo Suk

Abstract

Eighty-four cementless primary total knee arthroplasties were performed from June 1989 to May 1993, and the prevalence and characteristics of osteolysis were determined after a mean follow-up of 6.4 years(range, 5 to 8.1 years). Eighteen knees(21.4%) were identified as being associated with osteolysis, and the incidence of osteolysis was 10,7% for the femur and 13.1% for the tibia. Osteolysis was first noted radiographically at an average postoperative 4.7 years(range, 2.5 to 8, i years). Osteolysis of the femur was identified adjacent to the nonporous-coated regions of the anterior and posterior flanges of the components, The medial screw was more frequently associated with osteolytic lesion than the lateral one. Ten(55.6%) of the 18 prostheses were revised, 5 for advanced polyethylene wear, 3 for failed tibia1 fixation, and 2 for severe osteolysis. Significant factors associated with osteolysis were increased body weight(p<0.05) and malalignment(p<0.05). Femoral osteolysis was more common in Ortholoc design(20.0%) than in AMK design(4.1%). The AMK prosthesis(16.3%) showed higher in an incidence of screw osteolysis and tibial osteolysis than Ortholoc prosthesis(8.6%). The nonporous-coated flanges of the components and the polyethylene locking mechanism may be responsible for the differences in the incidence and region of osteolysis.