title: Osteolysis in a surface-cemented, primary, modular Freeman-Samuelson total knee replacement.
abstract: 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.
authors.affiliation: Department of Trauma and Orthopaedics, North Tyneside General Hospital, Rake Lane, North Shields, Northumbria NE29 8NH, UK. arorajayant@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Arora
authors.forename: A C
authors.initials: AC
authors.lastname: Ogden
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology*; D020959:Polyethylene; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D020959:Polyethylene