Osteolysis in a surface-cemented, primary, modular Freeman-Samuelson total knee replacement

• Published in: Journal of bone and joint surgery. British volume Vol. 87; no. 11; pp. 1502 - 1506
• Main Authors: ARORA, J, OGDEN, A. C
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01-11-2005; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Aged; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; Biological and medical sciences; Bone Cements; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; Knee Joint - diagnostic imaging; Knee Joint - physiopathology; Knee Prosthesis; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteolysis - diagnostic imaging; Osteolysis - etiology; Polyethylene; Prosthesis Failure; Prosthesis-Related Infections - surgery; Radiography; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Treatment Outcome; Total knee arthroplasty; Orthopedic surgery; Treatment; Osteolysis; Cement
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.87B11.16586

We analysed at a mean follow-up of 7.25 years the clinical and radiological outcome of 117 patients (125 knees) who had undergone a primary, cemented, modular Freeman-Samuelson total knee replacement. While the tibial and femoral components were cemented, the patellar component was uncemented. A surface-cementing technique was used to secure the tibial components. A total of 82 knees was available for radiological assessment. Radiolucent lines were seen in 41 knees (50%) and osteolytic lesions were seen in 13 knees (16%). Asymptomatic, rotational loosening of the patellar implant was seen in four patients and osteolysis was more common in patients with a patellar resurfacing. Functional outcome scores were available for 41 patients (41 knees, 35%) and the mean Western Ontario McMasters Universities score was 77.5 (sd 19.5) and the cumulative survival was 93.4% at ten years with revision for aseptic loosening as an endpoint. Increased polyethylene wear from modular components, a rotationally-loose patella, and the surface-cementing technique may have contributed to the high rate of osteolysis seen in our study.