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Knee Implant
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Total knee arthroplasty (TKA): Replacement of femoral, tibial, and patellar articular surfaces
            • Nonconstrained components
              • Generally, posterior cruciate ligament is retained
              • Other soft tissues, including collateral ligaments, provide stability
              • Concave polyethylene adds some constraint
            • Semiconstrained components
              • Usually long-stemmed
              • Peg extends from femoral side into central cylinder on tibial side; allows some rotation
                • Do not misinterpret lucency around peg as loosening of component
            • Constrained
              • Hinged femoral and tibial components; rarely used due to high rate of loosening
          • Single compartment (unicompartmental) implant: Medial, lateral, or patellofemoral
            • Considered when only single compartment involved with significant osteoarthritis
            • Not used if underlying process is inflammatory

        IMAGING

        • Radiographic Findings

          • CT Findings

            • MR Findings

              • Imaging Recommendations

                PATHOLOGY

                • Staging, Grading, & Classification

                  CLINICAL ISSUES

                  • Demographics

                    • Natural History & Prognosis

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        Selected References

                        1. Helito CP et al: Severe metallosis following total knee arthroplasty: a case report and review of radiographic signs. Skeletal Radiol. 43(8):1169-73, 2014
                        2. Plodkowski AJ et al: Lamellated hyperintense synovitis: potential MR imaging sign of an infected knee arthroplasty. Radiology. 266(1):256-60, 2013
                        3. Mannan K et al: The Medial Rotation total knee replacement: a clinical and radiological review at a mean follow-up of six years. J Bone Joint Surg Br. 91(6):750-6, 2009
                        4. Cobb JP et al: The anatomical tibial axis: reliable rotational orientation in knee replacement. J Bone Joint Surg Br. 90(8):1032-8, 2008
                        5. Mukherjee K et al: The Oxford unicompartmental knee arthroplasty: a radiological perspective. Clin Radiol. 63(10):1169-76, 2008
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Diagnostic Checklist

                              TERMINOLOGY

                              • Definitions

                                • Total knee arthroplasty (TKA): Replacement of femoral, tibial, and patellar articular surfaces
                                  • Nonconstrained components
                                    • Generally, posterior cruciate ligament is retained
                                    • Other soft tissues, including collateral ligaments, provide stability
                                    • Concave polyethylene adds some constraint
                                  • Semiconstrained components
                                    • Usually long-stemmed
                                    • Peg extends from femoral side into central cylinder on tibial side; allows some rotation
                                      • Do not misinterpret lucency around peg as loosening of component
                                  • Constrained
                                    • Hinged femoral and tibial components; rarely used due to high rate of loosening
                                • Single compartment (unicompartmental) implant: Medial, lateral, or patellofemoral
                                  • Considered when only single compartment involved with significant osteoarthritis
                                  • Not used if underlying process is inflammatory

                              IMAGING

                              • Radiographic Findings

                                • CT Findings

                                  • MR Findings

                                    • Imaging Recommendations

                                      PATHOLOGY

                                      • Staging, Grading, & Classification

                                        CLINICAL ISSUES

                                        • Demographics

                                          • Natural History & Prognosis

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Helito CP et al: Severe metallosis following total knee arthroplasty: a case report and review of radiographic signs. Skeletal Radiol. 43(8):1169-73, 2014
                                              2. Plodkowski AJ et al: Lamellated hyperintense synovitis: potential MR imaging sign of an infected knee arthroplasty. Radiology. 266(1):256-60, 2013
                                              3. Mannan K et al: The Medial Rotation total knee replacement: a clinical and radiological review at a mean follow-up of six years. J Bone Joint Surg Br. 91(6):750-6, 2009
                                              4. Cobb JP et al: The anatomical tibial axis: reliable rotational orientation in knee replacement. J Bone Joint Surg Br. 90(8):1032-8, 2008
                                              5. Mukherjee K et al: The Oxford unicompartmental knee arthroplasty: a radiological perspective. Clin Radiol. 63(10):1169-76, 2008