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Narrow, well-defined radiolucent lines commonly observed at the bone-implant interface of unicompartmental knee replacement tibial components have been referred to as physiological radiolucencies. These should be distinguished from pathological radiolucencies, which are poorly defined, wide and progressive, and associated with loosening and infection. We studied the incidence and clinical significance of tibial radiolucent lines in 161 Oxford unicondylar knee replacements five years after surgery. All the radiographs were aligned with fluoroscopic control to obtain views parallel to the tibial tray to reveal the tibial bone-implant interface. We found that 49 knees (30%) had complete, 52 (32%) had partial and 60 (37%) had no radiolucent lines. There was no relationship between the incidence of radiolucent lines and patient factors such as gender, body mass index and activity, or operative factors including the status of the anterior cruciate ligament and residual varus deformity. Nor was any statistical relationship established between the presence of radiolucent lines and clinical outcome, particularly pain, assessed by the Oxford Knee score and the American Knee Society score. We conclude that radiolucent lines are common after Oxford unicompartmental knee replacement but that their aetiology remains unclear. Radiolucent lines were not a source of adverse symptoms or pain. Therefore, when attempting to identify a source of postoperative pain after Oxford unicompartmental knee replacement the presence of a physiological radiolucency should be ignored.

Original publication

DOI

10.1302/0301-620x.91b7.21914

Type

Journal article

Journal

The Journal of bone and joint surgery. British volume

Publication Date

07/2009

Volume

91

Pages

896 - 902

Addresses

Botnar Research Centre, Nuffield Department of Orthopaedic Surgery, University of Oxford, UK.

Keywords

Tibia, Knee Joint, Humans, Prosthesis Failure, Radiographic Image Enhancement, Treatment Outcome, Arthroplasty, Replacement, Knee, Knee Prosthesis, Aged, Female, Male