CATASTROPHIC PERI-IMPLANT BONE LOSS CAUSED BY POLYETHYLENE AND METALLIC WEAR IN TOTAL KNEES

Two cases of massive bone loss associated with cementless total knee replacement are presented. The first case is unique in that a pathologic fracture of the distal femur occurred in association with catastrophic polyethylene failure. The second case shows bilateral failure associated with three-body wear of the polyethylene by detached CoCr beads. These cases point out the absolute necessity of routine clinical follow-up of cementless total knee replacement (TKR) and the necessity to intervene surgically if bone loss is discovered in spite of a painless clinical result.