Aseptic loosening is associated with medial tilting and anterior translational migration of the tibial implant in mechanically aligned total knee arthroplasty

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-26 DOI:10.1016/j.clinbiomech.2025.106474

Matthew D. Hickey , Bart L. Kaptein , Carolyn Anglin , Bassam A. Masri , Antony J. Hodgson

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引用次数: 0

Abstract

Background

Aseptic loosening is a significant cause of implant revision in total knee arthroplasty, and radiostereometric analysis has been used to predict loosening by measuring implant migration over time relative to its position at the time of the index surgery. Studies have suggested that analyzing specific migration patterns may improve prediction of loosening, compared to using measures of the Maximum Total Point Motion alone. Therefore, the objective of this study was to determine whether patients monitored using radiostereometric analysis who experienced either aseptic loosening or revision exhibited distinctive tibial implant migration patterns.

Methods

Extending a previous study using radiostereometric analysis, we calculated the 6-degree-of-freedom tibial implant migration patterns for seven patients with cemented mechanically aligned total knee arthroplasty implants who either developed aseptic loosening or were candidates for revision. We used simple linear regression to identify trends over time.

Findings

We observed two trends that achieved statistical significance: negative rotation in the coronal plane (medial tilting) of the tibial implant (b = 0.26⁰/month, p < 0.001) and anterior translation (b = 0.67 mm/month, p = 0.005).

Interpretation

Our study showed two statistically detectable migration trends associated with tibial component aseptic loosening. Although we were unable to assess in this study whether focusing on migration patterns in these directions provides greater predictive value than using Maximum Total Point Motion, the results suggest that certain migration mechanisms are more prevalent than others, which could motivate further research into the causes of such migration patterns.

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在机械对齐全膝关节置换术中，无菌性松动与胫骨植入物的内侧倾斜和前移位有关

无菌性松动是全膝关节置换术中假体翻修的一个重要原因，放射性立体分析已被用于通过测量假体相对于其在指数手术时的位置随时间的移动来预测松动。研究表明，与单独使用最大总点运动测量相比，分析特定的移动模式可以改善松动的预测。因此，本研究的目的是确定使用放射立体分析监测的经历无菌松动或翻修的患者是否表现出独特的胫骨植入物迁移模式。方法延续先前使用放射立体分析的研究，我们计算了7例骨水泥机械对齐全膝关节置换术假体患者的6自由度胫骨假体迁移模式，这些患者要么发生无菌性松动，要么需要翻修。我们使用简单的线性回归来确定随时间变化的趋势。结果：我们观察到两种具有统计学意义的趋势：胫骨种植体冠状面负旋转（内侧倾斜）(b = 0.260/月，p <；0.001)和前平移（b = 0.67 mm/月，p = 0.005）。我们的研究显示了两种统计上可检测的与胫骨成分无菌性松动相关的迁移趋势。虽然我们无法在本研究中评估关注这些方向的迁移模式是否比使用最大总点运动提供更大的预测价值，但结果表明，某些迁移机制比其他迁移机制更普遍，这可以激发对此类迁移模式原因的进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.