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📌 Polyethylene Wear in TKA
- Polyethylene components in Total Knee Arthroplasty (TKA) are susceptible to wear at the articular surfaces due to abrasion and fatigue.
- Repetitive rolling, sliding, and rotating at these surfaces result in scratching, burnishing, and pitting, along with the shedding of polyethylene particles.
- The particulate polyethylene debris stimulates a foreign-body inflammatory response, which can ultimately lead to osteolysis and loosening of the implant.
✅ Factors Influencing Polyethylene Wear
- Malalignment and instability can accelerate wear.
- The weight of the patient.
- The patient’s activity level.
- Molecular composition and thickness of the polyethylene.
- Articular irregularities adjacent to the polyethylene.
✅ Imaging of Polyethylene Wear
- Polyethylene wear can be identified on sequential radiographs as progressive joint space narrowing in anteroposterior and lateral weight-bearing views over the medial and lateral compartments.
- Wear should be evaluated on weight-bearing anteroposterior and lateral radiographs.
- The defect should be measured from the femoral condyles to the tibial baseplate. Moderate to severe wear appears as obvious joint space narrowing.
✅ NOTE: Asymmetry and Deformities
- When wear is asymmetric, varus or valgus deformity or patellar tilt may be present.
- However, asymmetry alone of the medial and lateral compartments is not a reliable indicator of wear as this appearance can also be secondary to ligamentous laxity.
References
- AJR 2017; 209:W231–W237
- Semin Musculoskelet Radiol 2019;23:e20–e35.
- Semin Musculoskelet Radiol 2017;21:147–164
- AJR 2014; 202:W76–W86
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#PolyethyleneWear, #TKA, #TotalKneeArthroplasty, #JointReplacement, #Radiology, #Orthopedics, #Osteolysis, #JointSpaceNarrowing, #MedicalImaging, #ImplantLoosening
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