The Effect of Bone Quality on Tibial Component Migration in Medial Cemented Unicompartmental Knee Arthroplasty. A Prospective Cohort Study Using Dual X-Ray Absorptiometry and Radiostereometric Analysis.
bone mineral density
implant migration
osteoarthritis of the knee
radiostereometric analysis
unicompartmental knee arthroplasty
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
29
08
2019
revised:
10
10
2019
accepted:
15
10
2019
pubmed:
17
11
2019
medline:
15
12
2020
entrez:
17
11
2019
Statut:
ppublish
Résumé
Periprosthetic bone mineral density (BMD) may influence implant fixation and subsequent loosening. Unicompartmental knee arthroplasty (UKA) restores normal knee kinematics and load distribution to the surrounding bone. We studied the influence of systemic and periprosthetic BMD of the proximal tibia on migration of the tibial component of cemented medial UKA. The cohort was dichotomized into a normal BMD group (T-score ≥ -1; n = 37) and a low BMD group (T-score < -1; n = 28) according to World Health Organization criteria. BMD of the proximal tibia and migration of the tibial component were measured with dual X-ray absorptiometry scans and stereoradiographs with 2-year follow-up. Patients with normal systemic BMD had an 11% to15% higher BMD in all regions of interest (ROIs) compared to patients with low systemic BMD throughout follow-up. Over time, a decrease in periprosthetic BMD in ROI 1-3 was seen for both groups. The operated knees and contralateral knees showed a similar reduction in BMD in all ROIs between preoperative and 24 months. Between 12 and 24 months, the normal BMD group migrated (maximal total point motion) 0.03 mm (95% confidence interval, -0.01, 0.08) and the low BMD group migrated 0.02 mm (95% confidence interval, -0.03, 0.07). Migration over time was not influenced by change in periprosthetic BMD. Migration of cemented medial tibial UKA was low until 24 months and was neither affected by preoperative systemic BMD nor affected by postoperative change in periprosthetic BMD. This suggests good long-term fixation despite an index difference in proximal tibial BMD.
Sections du résumé
BACKGROUND
Periprosthetic bone mineral density (BMD) may influence implant fixation and subsequent loosening. Unicompartmental knee arthroplasty (UKA) restores normal knee kinematics and load distribution to the surrounding bone. We studied the influence of systemic and periprosthetic BMD of the proximal tibia on migration of the tibial component of cemented medial UKA.
METHODS
The cohort was dichotomized into a normal BMD group (T-score ≥ -1; n = 37) and a low BMD group (T-score < -1; n = 28) according to World Health Organization criteria. BMD of the proximal tibia and migration of the tibial component were measured with dual X-ray absorptiometry scans and stereoradiographs with 2-year follow-up.
RESULTS
Patients with normal systemic BMD had an 11% to15% higher BMD in all regions of interest (ROIs) compared to patients with low systemic BMD throughout follow-up. Over time, a decrease in periprosthetic BMD in ROI 1-3 was seen for both groups. The operated knees and contralateral knees showed a similar reduction in BMD in all ROIs between preoperative and 24 months. Between 12 and 24 months, the normal BMD group migrated (maximal total point motion) 0.03 mm (95% confidence interval, -0.01, 0.08) and the low BMD group migrated 0.02 mm (95% confidence interval, -0.03, 0.07). Migration over time was not influenced by change in periprosthetic BMD.
CONCLUSION
Migration of cemented medial tibial UKA was low until 24 months and was neither affected by preoperative systemic BMD nor affected by postoperative change in periprosthetic BMD. This suggests good long-term fixation despite an index difference in proximal tibial BMD.
Identifiants
pubmed: 31732369
pii: S0883-5403(19)31004-6
doi: 10.1016/j.arth.2019.10.027
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
675-682.e2Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.