gms | German Medical Science

Objectives: The current study assesses the role of knee arthroscopy (KA) in patients with a recalled ExacTech total knee arthroplasty (TKA) and reports the rate of reoperation, component revision, or radiographic evidence of progressive osteolysis within the follow-up period.

Methods: A retrospective chart review was conducted on 38 patients who underwent KA after primary TKA with a recalled ExacTech implants between January 2022 and January 2023. Patient demographics, clinical outcomes, radiographic and MRI findings were analysed by a high-volume fellowship-trained arthroplasty surgeon.

Results and conclusion: Within a one year follow up 4/38 patients (10.5%) underwent revision TKA, 4/38 (10.5%) patients underwent repeat KA, and an additional 6/38 patients (15.8%) presented with concerning findings during the radiological review, resulting in an overall rate of failure of 14/38 patients (36.8%).Of the patients who had not undergone revision TKA or repeat KA, 29/30 patients (96.7%) demonstrated having signs of either possible/definite component loosening (5/30), radiolucent lines (25/30) or worsening osteolysis on radiographs (15/30). Additionally, upon review of patient MRIs, 28/30 patients (93.3%) had documentation of either persistent/progressive polymeric-induced synovitis or persistent/progressive osteolysis.

The high failure rate reported in the current study suggests that KA is not an adequate treatment for patients with polyethylene wear induced synovitis and osteolysis following the implantation of a recalled Exactech TKA. Delay of the definitive surgery can result in more severe bone defects. In patients with wear induced synovitis but without osteolysis or implant loosening polyethylene insert exchange might be the preferred alternative treatment.