Complications after total knee arthroplasty: how to manage patients with osteolysis.

Total knee arthroplasty generally is a highly successful orthopaedic procedure, but mechanical failure sometimes occurs. Debris particles, especially from polyethylene, can affect the long-term durability of the implant. Revision total knee arthroplasty is complex, and preoperative planning must consider alignment, stability, fixation, and knee motion. The reason for failure must be identified before complex reconstruction in the presence of osteolysis, and the procedure must appropriately augment the defective bone and place a stable, well-fixed implant.