E1647. Total Knee Arthroplasty from Templating to Revision
  1. Hoo Jung Rhim; Dongnam
  2. Krishna Cidambi; University of California San Diego
  3. Karen Cheng; University of California San Diego
With the aging population, there is increasing prevalence of osteoarthritis with an estimated prevalence of 54.5 million in the United States, a figure that is projected in increase to 78.4 million adults by 2040. Total knee arthroplasty (TKA) is increasing in popularity, with the projected number of TKA procedures reaching 3.48 million by the year 2030, as it allows patients with severe debilitation secondary to their arthritic joints to return to their desired activities without pain. This exhibit reviews the imaging involved in this procedure, beginning from preoperative planning to postoperative assessment of complications and managements.

Educational Goals / Teaching Points
This exhibit teaches radiologists and trainees to define the important features of the osteoarthritic knee in preoperative evaluation for total knee replacement, recognize the different types of primary arthroplasty components, describe the types of complications that may occur with total knee replacements, and understand the features of revision total knee prostheses.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This case-based exhibit presents the radiographic imaging findings in patients prior to and following left total knee replacement to show the imaging studies and measurements made on pre-operative evaluation, the radiographic features to distinguish different types of prostheses used in total knee arthroplasty (e.g., unicompartmental arthroplasty, patellofemoral resurfacing, posterior stabilized versus cruciate retaining prostheses), the often subtle features of prosthetic complications, including aseptic loosening, periprosthetic fracture, osteolysis, and prosthetic joint infection, as well as the postoperative appearance of the different types of revision components (constrained non-hinged, hinged).

With the increasing popularity of total knee replacement, radiologists need to be familiar with the different types of prostheses that may be encountered in routine practice and the types of complications that can occur with these surgeries. Radiographs are the mainstay of imaging both before and after TKR, and allow the radiologist to provide valuable information on the integrity of the implants.