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The Journal of Bone and Joint Surgery (American) 83:1545-1548 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Case Report

Tibial Osteolysis Associated with the Modular Tibial Tray of a Cemented Posterior Stabilized Total Knee Replacement

A Case Report

Mark W. Pagnano, MD, Giles R. Scuderi, MD and John N. Insall, MD

Investigation performed at the Insall-Scott-Kelly Institute for Orthopaedics and Sports Medicine, New York, NY
Mark W. Pagnano, MD
Department of Orthopaedic Surgery, Mayo Clinic and Mayo Foundation, 200 First Street S.W., Rochester, MN 55905. Please address requests for reprints to M.W. Pagnano.

Giles R. Scuderi, MD
Insall-Scott-Kelly Institute for Orthopaedics and Sports Medicine, 170 East End Avenue, New York, NY 10128

John N. Insall, MD
Deceased

One or more of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.


   Introduction
 
Osteolysis around total knee arthroplasty components has been described predominantly in association with posterior cruciate ligament-retaining knee designs1-4. Most of these implants had been inserted without bone cement and had relatively nonconforming articular surfaces and a thin tibial polyethylene insert5-9. In contrast, to our knowledge, neither clinically apparent wear of the polyethylene of the tibial component nor extensive osteolysis has been reported in association with the classic posterior stabilized total knee prosthesis (Insall-Burstein; Zimmer, Warsaw, Indiana)10,11.

The posterior stabilized prosthesis incorporates a post-and-cam mechanism that provides for controlled rollback of the femur when the knee is flexed and that incorporates moderate conformity of the tibiofemoral articulation in both the sagittal and the coronal plane. That conformity reduces stress on the polyethylene bearing surface and may account for the favorable wear characteristics of the prosthesis12-16. Recently, concerns have emerged about the potential for marked wear occurring on . . . [Full Text of this Article]


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M. W. Hanna and T. S. Thornhill
Thigh Mass and Lytic Diaphyseal Femoral Lesion Associated with Polyethylene Wear After Hybrid Total Knee Arthroplasty. A Case Report
J. Bone Joint Surg. Am., November 1, 2006; 88(11): 2473 - 2478.
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