Dalling Jason G, Math Kevin, Scuderi Giles R
J Am Acad Orthop Surg. 2015 Mar;23(3):173-80. doi: 10.5435/JAAOS-D-13-00189. Epub 2015 Feb 9.
Osteolysis around the knee following total knee arthroplasty continues to be a leading cause for revision total knee arthroplasty. Risk factors for periprosthetic knee osteolysis are associated with excessive polyethylene wear and include, but may not be limited to, malalignment of the mechanical axis, early-generation polyethylene sterilization techniques, excessive backside polyethylene wear, metal-backed patellar components, patient age, and an elevated body mass index. The initial diagnosis of osteolysis is frequently discovered on routine surveillance radiographs. The location, size, progressive nature, and associated symptomatology of the defect guides treatment. Surgical indications and timing are predicated on the risk of failure with continued observation. Advanced imaging helps to quantitate the size and location of osteolytic lesions as accurately as possible and aids in preoperative planning. When deciding whether surgery or management with continued radiographic surveillance is indicated, a global assessment of the character and progression of the osteolysis must be weighed with the risk factors associated with the patient.
全膝关节置换术后膝关节周围的骨溶解仍然是翻修全膝关节置换术的主要原因。假体周围膝关节骨溶解的危险因素与聚乙烯过度磨损有关，包括但不限于机械轴排列不齐、早期聚乙烯灭菌技术、聚乙烯背面过度磨损、金属背髌骨组件、患者年龄和体重指数升高。骨溶解的初步诊断通常在常规监测X线片上发现。缺损的位置、大小、进展性质和相关症状指导治疗。手术指征和时机取决于继续观察的失败风险。先进的影像学有助于尽可能准确地量化骨溶解病变的大小和位置，并有助于术前规划。在决定是进行手术还是继续进行影像学监测时，必须综合考虑骨溶解的特征和进展情况以及与患者相关的危险因素。
