Screw Osteolysis Total Knee Replacement Arthroplasty

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the prevalence and the pattern of osteolysis around screws and the clinical results of total knee replacement arthroplasty with the fixation of tibial implant with screws. MATERIALS AND METHODS: This study group was consisted of 31 knees of 23 patients, followed up for at least 5 years were reviewed. The American Knee Society Evaluation System was used for the clinical and radiological assessment. We also analyzed pattern and prevalence of the osteolysis around the screws by the Lewis classification. RESULTS: The American Knee Society knee score and function score were improved from a mean of 30, 20 points preoperatively to 91, 88 points postoperatively. The 2l tibial trays in 31 tibial components developed non progressive radiolucent lines with average of 1.7 points radiolucent score. In the last follow-up radiographic findings of osteolysis around screw were detected in 25 screws among total 122 screws. All 25 screws showed screw related osteolysis pattern as type l(linear) and neither cystic nor cavitary change were found. CONCLUSION: We suspected that the autogenous caneellous bone graft around the peg hole, before the insertion of the screw, prevented cystic or cavitary lesion around the screws in total knee replacement arthroplasty, but more long-term follow-up is needed.