PMC5458694_01
Computed tomography and tomosynthesis of the knee. (a) Computed tomography taken at 6 weeks postoperatively showing loosening around the tibial component. (b) Tomosynthesis taken after 6 months of teriparatide therapy showing no spaces between the tibial component and the osteotomy load surface. (c) Computed tomography taken at 1 year postoperatively showing no spaces beneath the tibial component.
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TKA (Cementless Vanguard, Biomet, Warsaw, IL, USA) in November, 2012, for severe osteoarthritis of the left knee (Fig. 1). The medical history included hypertension treated with oral amlodipine and losartan. At 5 weeks postoperatively, knee radiography showed radiolucent lines outlined beneath the tibial tray and around the stem (Fig. 1). Knee radiography at this time exhibited a decrease of previously observed radiolucent lines (Fig. 1). Knee radiography at 1 year postoperatively showed no radiolucent lines around either the femoral or tibial components and an increase in sclerosis at the pedestal (Fig. 1).
Radiography of the knee. (a) Plain film of the knee with osteoarthritis before total knee arthroplasty. (b) Plain film taken immediately following the operation. (c) Plain film taken at 5 weeks postoperatively showing radiolucent lines at entire circumference around the tibial tray. (d) Plain film taken after 2 months of teriparatide therapy showing a decrease of previously observed radiolucent lines. (e) Plain film taken at 1 year postoperatively showing complete ingrowth to the tibial bone.
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At 6 weeks postoperatively, computed tomography was conducted, which clearly showed loosening around the tibial component (Fig. 2). After 6 months of teriparatide therapy, the patient achieved tomosynthesis, and no space between either femoral or tibial components and the osteotomy load surfaces was observed (Fig. 2). Although some artifacts were observed around pegs, the implant still achieved ingrowth to the bone (Fig. 2).