Wear and Loosening in Total Knee Arthroplasty: A Quick Review

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.