Preoperative Systemic Bone Quality Does Not Affect Tibial Component Migration in Knee Arthroplasty: A 2-Year Radiostereometric Analysis of a Hundred Consecutive Patients.
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee
Bone Cements
Bone Density
Female
Humans
Knee Joint
/ surgery
Knee Prosthesis
Male
Middle Aged
Osteoarthritis, Knee
/ diagnostic imaging
Postoperative Period
Prospective Studies
Prosthesis Failure
Radiostereometric Analysis
Surveys and Questionnaires
Tibia
/ surgery
RSA
bone mineral density
bone turnover markers
knee arthroplasty
migration
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
27
02
2019
revised:
27
04
2019
accepted:
09
05
2019
pubmed:
17
6
2019
medline:
4
9
2020
entrez:
17
6
2019
Statut:
ppublish
Résumé
Bone quality and other preoperative predictive factors may affect implant migration and the survival of knee arthroplasty. In a prospective cohort of 100 consecutive patients (65 women) at a mean age of 67.7 years (range 39-87 years), we investigated preoperative predictors of postoperative tibial component migration in cemented and cementless total knee arthroplasties or cemented unicompartmental knee arthroplasty. Predictors consisted of Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score, questionnaires, bone turnover markers of CTX and P1NP, systemic bone mineral density (BMD), and knee osteoarthritis (OA) grade. Tibial component migration was measured with radiostereometry postoperative, at 1 and 2 years of follow-up. Between 1 and 2 years, 19 tibial components migrated continuously (maximum total point motion [MTPM] > 0.2 mm). In general, there was no difference in age, body mass index, BMD, KOOSs, or OA grade between patients with continuous tibial migration compared to patients without continuous migration (P > .11). However, cementless tibial components with continuous migration had a lower KOOS pain score (more pain), lower vitamin D, and a higher bone turnover (CTX) value than patients without continuous migration. There was no association between the BMD and MTPM at 1-year follow-up regardless of prothesis type (P > .17). Patients with osteoporosis and normal BMD had similar mean tibial component MTPM at 2 years (3 prostheses combined; P = .34). Migration of tibial components inserted with or without bone cement was not affected by the preoperative bone quality in terms of systemic BMD, bone turnover markers, and OA grade in the knee.
Sections du résumé
BACKGROUND
Bone quality and other preoperative predictive factors may affect implant migration and the survival of knee arthroplasty.
METHODS
In a prospective cohort of 100 consecutive patients (65 women) at a mean age of 67.7 years (range 39-87 years), we investigated preoperative predictors of postoperative tibial component migration in cemented and cementless total knee arthroplasties or cemented unicompartmental knee arthroplasty. Predictors consisted of Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score, questionnaires, bone turnover markers of CTX and P1NP, systemic bone mineral density (BMD), and knee osteoarthritis (OA) grade. Tibial component migration was measured with radiostereometry postoperative, at 1 and 2 years of follow-up.
RESULTS
Between 1 and 2 years, 19 tibial components migrated continuously (maximum total point motion [MTPM] > 0.2 mm). In general, there was no difference in age, body mass index, BMD, KOOSs, or OA grade between patients with continuous tibial migration compared to patients without continuous migration (P > .11). However, cementless tibial components with continuous migration had a lower KOOS pain score (more pain), lower vitamin D, and a higher bone turnover (CTX) value than patients without continuous migration. There was no association between the BMD and MTPM at 1-year follow-up regardless of prothesis type (P > .17). Patients with osteoporosis and normal BMD had similar mean tibial component MTPM at 2 years (3 prostheses combined; P = .34).
CONCLUSION
Migration of tibial components inserted with or without bone cement was not affected by the preoperative bone quality in terms of systemic BMD, bone turnover markers, and OA grade in the knee.
Identifiants
pubmed: 31202639
pii: S0883-5403(19)30493-0
doi: 10.1016/j.arth.2019.05.019
pii:
doi:
Substances chimiques
Bone Cements
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2351-2359Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.