Total knee arthroplasty aseptic loosening
Classic history and presentation: Early in the course of post-TKA aseptic loosening, patients might not report any pain at all; however, with progression of this pathology, patients will report atraumatic onset of pain localized to the replaced joint and surrounding tissues with weight-bearing and activity (usually painless at rest). The patient may report classic start-up pain, which is described as pain during the beginning of ambulation that may improve temporarily but then increase with longer periods of ambulation.
- Age – No age bias.
- Sex / gender – No predilection toward any gender.
- Polyethylene implant composition (early conventional polyethylene was found to be less wear resistant compared to newer ultra-high molecular weight and highly crosslinked polyethylene liners).
- Older polyethylene sterilization methods in oxygen-rich environments led to decreased wear resistance.
- Unpolished tibial trays can lead to backside of the polyethylene liner.
- Presence of debris in joint causing third-body wear.
- High activity level of the patient.
- Component malposition at index surgery, leading to preferential and abnormal loading pattern.
- TKA instability.
T84.039A – Mechanical loosening of unspecified internal prosthetic joint, initial encounter
281450006 – Loosening of total knee replacement