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Statistical analysis was not performed here because of the relatively small sample size of the loose component group and the wide range of responses for the loose group.
The problem of asymptomatic destruction of bone stock by a loose component [ 25- 28] makes regular radiographic follow-up the only viable monitoring option.
However, when revision, radiographic evidence of a loose component, and recurrence of pain were all used as determinants of failure, the cumulative rate of success was only 75percentnt.
* Failure was considered to have occurred when the arthroplasty had to be revised or did not have to be revised but was more than mildly painful, or when there was radiographic evidence of a loose component.
The analysis showed that the proportions of patients with radiological loosening signs are constantly increasing during the 4 5 years before an exchange of one or both mechanically loose components and that nearly all patients have a radiographically loose component and/or relevant, i.e. moderate, severe or intolerable pain in the revision year.
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The first system consists of loose components and in the second system the components are integrated.
Greater levels of damage were present on both surfaces in components with greater radiographic radiolucency scores and mechanically loose components.
The third research question addresses the question of how much motion is present at the stem-cement and cement-bone interfaces for radiographically well-fixed components as compared to loose components.
Loose components without gross osteolysis were present in 2 of 9 patients, osteolysis in 4 patients, synovitis in 5 patients, pseudotumor in 5 patients, and destructive muscle loss in 3 patients.
On the basis of our results, we conclude that SPECT/CT is of great clinical value for the assessment and guidance of subsequent treatment in painful knees after TKA, particularly in patients with patellofemoral problems, malpositioned or loose components.
However, alongside these encouraging durability results, first-generation MOM studies also demonstrated metal wear debris in tissues adjacent to the implants, particularly in prostheses with loose components or impingement (Howie 1990).
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