Laury Angenent, Robin Van Kempen
A 73-year-old female with a history of thrombosis and anemia presented with bilateral knee pain and an inability to walk. Clinical examination and radiographs showed extensive bilateral periprosthetic osteolysis (PPOL) without signs of inflammation. She successfully underwent bilateral revision arthroplasty with ligament reconstruction. PPOL is a multifactorial process in which radiologic findings may not correlate with the clinical presentation. This case supports the discussion of whether long-term follow-up is sufficient or earlier intervention is warranted.