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Sonography of Polyethylene Liners Used in Total Knee Arthroplasty

Carolyn M. Sofka1,2, Ronald S. Adler1,2 and Richard Laskin3

1 Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th St., New York, NY 10021.
2 Department of Radiology, Weill Medical College of Cornell University, New York, NY 10021.
3 Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021.



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  		Fig. 1. —67-year-old man who underwent total knee arthroplasty. Anteroposterior radiograph obtained with patient standing shows normal radiographic appearance of radiolucent polyethylene liner (arrows) in implant.

 


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  		Fig. 2. —Longitudinal sonographic image obtained along lateral joint line in 80-year-old woman with total knee arthroplasty shows sonographic appearance of metal–bone–polyethylene interface in total knee arthroplasty. Polyethylene (thick arrow) is being measured by electronic calipers. Note linear echogenic interface superficially and posterior acoustic shadowing generated by polyethylene. In contrast, that with metallic tibial and femoral components (thin arrows) shows posterior reverberation artifacts. A = 0.96 cm.

 


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  		Fig. 3. —Longitudinal sonographic image of 80-year-old man who underwent total knee arthroplasty shows relatively thick (15.8 mm) polyethylene liner (arrow).

 


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  		Fig. 4. —Graph shows correlation (r2 = 0.6283) between sonographic measurements along medial joint line and radiographic measurements as obtained on anteroposterior radiographs with patients standing. y = 1.2105x – 1.0879.

 


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  		Fig. 5. —Graph shows high correlation between sonographic and radiographic measurements (r2 = 0.6584) between sonographic measurements obtained along lateral joint line and radiographic measurements. y = 1.009x – 0.7588.

 


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  		Fig. 6. —Graph depicts relationship between the sonographic measurements along medial joint line and stated manufacturers' size of liner. Note relatively poor correlation (r2 = 0.2857). This discrepancy is likely due to the fact that manufacturers' stated size of spacer is only minimum polyethylene thickness present.

 

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