Pathological Radiolucency, Incidence, and Its Progression to Loosening After Revision Total Knee Arthroplasty.

Introduction Increased primary TKA will invite more revision rates due to failure in some percentage of cases. Some studies allocate the aseptic loosening on the top of causes of failure, accounting for 39.9% of revisions. Radiolucent lines on conventional x-rays can used in diagnosis of loosening, radiolucent lines may be developed early within a normal pain free knee. Patient and methods Patients who underwent RTKA between 2015 and 2022 in specialized knee center were retrospectively reviewed. Focusing on tibial side, the radiographic results were assigned into two groups, no radiolucency if no lines were detected or these lines are non-progressive on serial x-rays. Results The mean age was 66.5±8.68, most of the patients were above 60 years, the mean follow- up period was 3.5± 1.3 years. Sixty-one patients (26.07%) were allocated in the pathological radiolucency group, ten patients (16.39%) became loose and revised. there was a statistically significant difference (P< 0.001) with height progression to loosening in the pathological radiolucency group. conclusion Pathological radiolucent lines on radiographs are a good diagnostic tool that may raise the attention towards close monitoring and follow up of the patient to avoid complications and patient disability.