title: Wear and loosening in total knee arthroplasty: a quick review.
abstract: Wear and osteolysis are common problems that often require revision surgery following total knee arthroplasty (TKA). Wear rates can be reduced through proper implant positioning and the use of modern, highly cross-linked polyethylene liners. More research is needed to identify medications that could prevent or treat the bone loss associated with osteolysis. Bone defects resulting from osteolysis can be managed with a variety of bone-preserving strategies and often require the use of structural augmentation, either in the form of bulk allografts or metal augments. Recently, porous metal augments such as tantalum cones have gained popularity among surgeons performing revision TKA for osteolytic bone defects with promising early clinical results. A megaprosthesis with a rotating hinge device may be used in salvage cases for severe bone deficiencies.
authors.affiliation: Department of Orthopedics, Banner Good Samaritan Hospital, Phoenix, Arizona.
authors.forename: James F
authors.initials: JF
authors.lastname: Fraser
authors.affiliation: Division of Adult Reconstruction, The CORE Institute, Center for Orthopedic Research and Education, Phoenix, Arizona.
authors.forename: Steven
authors.initials: S
authors.lastname: Werner
authors.affiliation: The CORE Institute, Center for Orthopedic Research and Education, Phoenix, Arizona.
authors.forename: David J
authors.initials: DJ
authors.lastname: Jacofsky
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016025:Bone Transplantation; D003343:Corrosion; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects*; D010014:Osteolysis / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation