✅ Knee MRI Mastery/Chap 5AB. Chondral and osteochondral

Polyethylene wear–induced synovitis

MSK MRI 2023. 12. 29. 23:02
Polyethylene Wear
 
Polyethylene components used in total knee arthroplasty (TKA) can experience wear on the articular surfaces due to abrasion and fatigue
 This wear generates polyethylene debris, which triggers an inflammatory response.
Over time, this response can lead to osteolysis and loosening.
Radiographic Findings of Polyethylene Wear
  Progressive joint space narrowing Sequential radiographs show a joint space narrowing over the medial and lateral compartments, indicating polyethylene wear.
Asymmetric wear An uneven polyethylene wear pattern was observed on weight-bearing views, leading to valgus or varus deformities or patellar tilt.
Moderate to severe wear The obvious joint space narrowing indicates significant polyethylene wear.
MRI findings  of Polyethylene Wear
  Polyethylene wear–induced synovitis (61) (60) Greater synovial proliferation observed on MRI corresponds with increased polyethylene wear.
Frondlike synovial proliferation, thickened synovium, and intra-articular debris are seen.
Dissociation of Polyethylene Insert (53) Rare occurrence where the polyethylene tibial insert becomes dislodged due to the dislodgement of the locking screw or pin.
Linear signal hyperintensity observed between the polyethylene tibial insert and tibial tray on MRI indicates the presence of dissociation.

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