Background. Traditionally,
osteolysis around total knee replacements (TKRs) is treated with complete revision. In certain subsets,
polyethylene insert exchange and
bone grafting may be applicable. This study reports the clinical outcomes for selective
bone grafting in patients with
osteolysis without complete revision of the TKR. Methods. This retrospective study analyzes 10 TKRs (9 patients, 66.5 ± 6.1 years old) presenting with
osteolysis and revised after 8.7 ± 1.9 years of in vivo function. At index TKR, all patients were implanted with uncemented
prosthesis and modular
polyethylene insert with anteroposterior articular constraint (Ultracongruent, Natural Knee II, Sulzer Medica). The surgical technique for treating the
osteolysis included removal of necrotic bone tissue using
curettage, filling of the defect with bone graft materials, and
polyethylene insert exchange. Results. Patients have not exhibited any further complications associated with
osteolysis after 5.1 ± 2.4 years of followup. Routine radiographic exams show total incorporation of the graft material into the previously lytic regions in all patients. Conclusion. In some TKRs with
osteolysis and firmly fixed components, the removal of lytic tissue and subsequent defect filling with bone graft materials can be a viable
solution. This case series shows complete resolution of
osteolysis in all patients with no complications.