Does Computed Tomography Add Information on Radiographic Analysis in Detecting Periprosthetic Osteolysis After Total Ankle Arthroplasty?

Background: The major longer term complications of ankle arthroplasty are periprosthetic osteolysis and aseptic loosening. Follow-up studies of total hip arthroplasties show that measurements of periprosthetic osteolytic lesions on radiographs underestimate the size compared with those made on compu...

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Bibliographic Details
Published in:Foot & ankle international 2013-02, Vol.34 (2), p.180-188
Main Authors: Kohonen, Ia, Koivu, Helka, Pudas, Tomi, Tiusanen, Hannu, Vahlberg, Tero, Mattila, Kimmo
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty, Replacement, Ankle - adverse effects
Female
Follow-Up Studies
Humans
Joint Prosthesis
Male
Middle Aged
Osteolysis - diagnostic imaging
Retrospective Studies
Talus - diagnostic imaging
Tibia - diagnostic imaging
Tomography, Spiral Computed
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Summary:Background: The major longer term complications of ankle arthroplasty are periprosthetic osteolysis and aseptic loosening. Follow-up studies of total hip arthroplasties show that measurements of periprosthetic osteolytic lesions on radiographs underestimate the size compared with those made on computed tomography (CT), and some of the lesions may even remain undetected on radiographs. However, it is unclear whether the same applies to total ankle arthroplasty (TAA). Methods: We retrospectively reviewed the radiographs of 123 patients who had undergone TAA with the Ankle Evolutive System (AES) implant. Of these, 43 (34.9%) had at least 1 large (greater than 10 mm) osteolytic lesion on radiographs at a minimum follow-up of 14 months (mean, 43.1 months; range, 14-85 months). Forty of the 43 patients underwent helical CT imaging. Results: Computed tomography showed more osteolytic lesions than radiographs around both tibial and talar components. CT also showed larger lesions than radiographs in 9 of 10 zones around prosthetic components. The difference was highly significant in 3 zones around the talar component. Conclusion: Computed tomography showed more and larger periprosthetic lesions than radiographs around an ankle prosthesis. Because osteolysis is progressive in nature, it presumably leads to component failure. Considering our results, we recommend adding CT imaging to postoperative follow-up after TAA for patients with suspected or known periprosthetic lucencies on radiographs. Level of Evidence: Level III, diagnostic study.
ISSN:1071-1007
1944-7876
DOI:10.1177/1071100712460224