RT Journal
A1 Scuderi, Giles R.
T1 Complications After Total Knee ArthroplastyHow to Manage Patients with Osteolysis
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD November 16
VO 93
IS 22
SP 2127
OP 2135
DO 10.2106/JBJS.9322icl
UL http://dx.doi.org/10.2106/JBJS.9322icl
AB 
Total knee arthroplasty is one of the most successful orthopaedic procedures. It improves quality of life and has high patient satisfaction and excellent longevity, with survivorship of >90% at fifteen to twenty years. However, mechanical failure remains a complication. Debris particles, especially from polyethylene, affect the long-term durability of the implants1-3. Polyethylene debris incites a chemical and cellular inflammatory reaction, resulting in bone resorption and osteolysis. The extent of the osteolysis is dependent on the volume, size, and shape of the polyethylene debris. The main causative factor leading to osteolysis is small particulate debris, which stimulates an inflammatory foreign-body cellular response, resulting in bone resorption4. In contrast, the large polyethylene particles associated with delamination of the polyethylene and fatigue wear do not elicit the same cellular response2,3.