Abstract
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.
Keywords
wear - osteolysis - bone defects - revision total knee arthroplasty
