ABSTRACT
This study determined the accuracy of plain radiography in detecting osteolytic lesions
around total knee prostheses compared to multi-detector computed tomography (CT).
Thirty-one patients diagnosed with periprosthetic osteolysis by multi-detector CT
after total knee arthroplasty (TKA) were studied. Computed tomography for each patient
was retrospectively reviewed in a blinded fashion. The plain radiographs for each
patient that had been obtained prior to CT were reviewed in the same manner. The results
of the CT were compared with the results of the radiographs. The number, size, and
location of the lesions were compared. The multi-detector CT detected 48 lesions in
31 knees: 40 tibial lesions, 4 femoral lesions, and 4 patellar lesions. Radiographic
diagnosis was made in 6 of the 40 tibial lesions, 2 of the 4 femoral lesions, and
0 of the 4 patellar lesions. Plain radiographs are inadequate for evaluating periprosthetic
osteolysis in TKA with only 8 (17%) of 48 lesions detected by multi-detector CT visible
on the standard radiographs. Multi-detector CT provides the surgeon with a diagnostic
and preoperative planning tool when osteolysis is suspected.
