Aseptic loosening - knee arthroplasty

Case contributed by Domenico Nicoletti
Diagnosis certain


Follow-up knee arthroplasty.

Patient Data

Age: 60 years
Gender: Male

In total knee arthroplasty (one year ago), typical peri-prosthetic radiolucent lines (>2 mm) surround the cementless femoral and tibial stem, most evident at the tibial component.

Periprosthetic fracture of tibia without trauma treated with open reduction internal fixation (ORIF) using locking plates.

Case Discussion

Aseptic loosening is the failure of the joint prosthesis without the mechanical cause or infection with bone resorption and inflammatory cellular response within the joint. A radiolucent line >2 mm at the bone-prosthesis interface or at the bone-cement interface indicates loosening, particularly if it tends to increase in subsequent checks. Radiolucent lines without clinical symptoms should be monitored with targeted radiological tests to avoid complications such as periprosthetic fractures.

TSRM: Nunzio Bianco

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