scholarly journals The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

Author(s):  
Jenna M. Wahbeh ◽  
Sang-Hyun Park ◽  
Patricia Campbell ◽  
Edward Ebramzadeh ◽  
Sophia N. Sangiorgio

Abstract Background Periprosthetic bone loss is a common observation following arthroplasty. Recognizing and understanding the nature of bone loss is vital as it determines the subsequent performance of the device and the overall outcome. Despite its significance, the term “bone loss” is often misused to describe inflammatory osteolysis, a complication with vastly different clinical outcomes and treatment plans. Therefore, the goal of this review was to report major findings related to vertebral radiographic bone changes around cervical disc replacements, mitigate discrepancies in clinical reports by introducing uniform terminology to the field, and establish a precedence that can be used to identify the important nuances between these distinct complications. Methods A systematic review of the literature was conducted following PRISMA guidelines, using the keywords “cervical,” “disc replacement,” “osteolysis,” “bone loss,” “radiograph,” and “complications.” A total of 23 articles met the inclusion criteria with the majority being retrospective or case reports. Results Fourteen studies reported periprosthetic osteolysis in a total of 46 patients with onset ranging from 15–96 months after the index procedure. Reported causes included: metal hypersensitivity, infection, mechanical failure, and wear debris. Osteolysis was generally progressive and led to reoperation. Nine articles reported non-inflammatory bone loss in 527 patients (52.5%), typically within 3–6 months following implantation. The reported causes included: micromotion, stress shielding, and interrupted blood supply. With one exception, bone loss was reported to be non-progressive and had no effect on clinical outcome measures. Conclusions Non-progressive, early onset bone loss is a common finding after CDA and typically does not affect the reported short-term pain scores or lead to early revision. By contrast, osteolysis was less common, presenting more than a year post-operative and often accompanied by additional complications, leading to revision surgery. A greater understanding of the clinical significance is limited by the lack of long-term studies, inconsistent terminology, and infrequent use of histology and explant analyses. Uniform reporting and adoption of consistent terminology can mitigate some of these limitations. Executing these actionable items is critical to assess device performance and the risk of revision. Level of Evidence IV Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

2020 ◽  
Vol 8 (21) ◽  
pp. 5284-5295
Author(s):  
Xiao-Fei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Ying Hong ◽  
Bei-Yu Wang

2005 ◽  
Vol 440 (&NA;) ◽  
pp. 178-183 ◽  
Author(s):  
Mohammad Arabmotlagh ◽  
Thorsten Hennigs ◽  
Joerg Warzecha ◽  
Markus Rittmeister

2020 ◽  
Vol 136 ◽  
pp. e407-e418 ◽  
Author(s):  
Xiaofei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Ying Hong ◽  
Beiyu Wang

2017 ◽  
Vol 89 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Terje O Ugland ◽  
Glenn Haugeberg ◽  
Svein Svenningsen ◽  
Stein H Ugland ◽  
Øystein H Berg ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document