Radiolucent lines around knee arthroplasty components : a narrative review.

Radiolucent lines around knee arthroplasty components : a narrative review. Acta Orthop Belg. 2020 Mar;86(1):82-94 Authors: Wautier D, Ftaïta S, Thienpont E Abstract Aseptic loosening of total knee arthroplasty (TKA) components is one of the frequent reasons for early revision together with infection and instability. Aseptic loosening is usually preceded by the observation of radiolucent lines (RLL) on radiographs. Radiolucent lines have conventionally been considered a sign of osteolysis due to particles disease of either polyethylene or cement wear. However, RLL can be observed quite early after TKA, way before wear and osteolysis can even occur. Immediate postoperative RLL are secondary to surgical technique with either inadequate cement penetration in sclerotic bone, insufficient preparation of the bone or malpositioning of the component relative to the bone cuts. This type of RLL can be observed radiologically but remains often without clinical symptoms. Early development of RLL, on an initially satisfying radiograph, is secondary to changes to the cement-bone interface. These are most often related to micromotion because of constraint, malalignment, remaining mechanical deformity, erroneous bone cuts or osteoporosis. This type of RLL are observed progressively on follow-up radiographs and can be accompanied by pain complaints despite of initial good outcome. Young age, male sex or osteoporotic bones often found in elderly fema...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research