Removed knee prosthesis due to osteolysis!
This patient underwent a total knee arthroplasty (TKA) or replacement. One major late complications of such procedure is osteolysis, which ranks as the most significant cause of revision surgery in both total and knee arthroplasties.
Osteolysis simply means an active resorption of bone matrix by osteoclasts (a bone cell that breaks down bone tissue). This patient developed osteolysis of both femoral condyles following a low grade infection and required revision surgery of for his knee arthroplasty, based upon the degree of implant stability and the magnitude of bone loss.
Generally speaking, osteolysis in TKA is associated with aseptic loosening and other wear-related complications.
The process of aseptic loosening is initially governed by factors such as implant/limb alignment, device fixation quality, and muscle coordination/strength. Later large numbers of wear particles detached from TKAs trigger and perpetuate particle disease, highlighted by progressive growth of inflammatory/granulomatous tissue around the joint cavity. An increased accumulation of osteoclasts at the bone-implant interface, an impairment of osteoblast function, mechanical stresses, and an increased production of joint fluid contribute to bone resorption and subsequent loosening of the implant.
In addition, hypersensitivity and adverse reactions to metal debris may interfere and cause osteolysis.
Photo by @nyc_lyd