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. 2022 Jan;10(1):85-91.
doi: 10.22038/ABJS.2021.54610.2723.

Incidence of Radiolucent Lines after Cemented Total Knee Arthroplasty

Hannah Jia Hui Ng  1 , Gabriel Kai Yang Tan  2 , Ryan Gabriel Tan  3 , Chung Yuan Kau  1
Affiliations

Incidence of Radiolucent Lines after Cemented Total Knee Arthroplasty

Hannah Jia Hui Ng et al. Arch Bone Jt Surg. 2022 Jan.

Abstract

Background: Cemented Total Knee Arthroplasty (TKA) provides excellent long-term survival rates and functional results, however, radiolucent lines (RLLs) often appear during early post-operative follow-up and their incidence and clinical significance are unknown. The primary aim was to establish the incidence, location, frequency, and time taken for RLLs to appear within the first year after a primary cemented TKA with an anatomic tibial baseplate (Smith and Nephew, LEGION Total Knee System).

Methods: This was a retrospective analysis of 135 primary cemented TKA in 131 patients over three years. We compared demographics, serial radiographs, and early clinical and functional outcomes.

Results: There were 65 TKAs (48%) in 62 patients who had RLLs within the first year post-operatively. Most were females (58.8%). Mean age was 68.3 ± 7.9 years. There were 88 RLLs, with the most and second commonest location at the medial tibial baseplate (38%) and anterior femoral flange (23%). 89% were in the bone-cement interface. The largest average length of RLLs were at the anterior flange of the femoral component (1.98 ± 1.33 mm). The average time to development was 6.5 ± 4.1 months. None of these patients had infections nor required revision. Patients with RLLs did not do worse in functional and clinical scoring at 1-year.

Conclusion: There was a 48% incidence of physiological RLLs after cemented TKA, with the highest occurrence at the medial tibial baseplate at 38%. These radiolucent lines did not affect early post-operative clinical and functional outcomes of patients.

Keywords: Cemented; Radiolucency; Total Knee Arthroplasty; Total Knee Replacement.

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Figures

Figure1
Figure1
(A) AP views of the tibial component; (B and C) lateral views of the tibial and femoral component showing zone classification
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