Periprosthetic tibial bone mineral density changes after total knee arthroplasty: one-year follow-up study of 69 patients.

Tarja A Soininvaara, Hannu J A Miettinen, Jukka S Jurvelin, Olavi T Suomalainen, Esko M Alhava, Heikki P Kröger
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引用次数: 77

Abstract

Background: The critical structure supporting the prosthetic components in total knee arthroplasty (TKA) is tibial trabecular bone. The quality of tibial bone can be evaluated by bone mineral density (BMD) measurements.

Patients and methods: We prospectively measured changes in BMD in the proximal tibia after cemented TKA in osteoarthrotic knees. 69 patients were scanned by dual-energy X-ray absorptiometry (DXA) within a week after surgery, and after 3, 6 and 12 months.

Results: At baseline, the medial region of interest (ROI) BMD was higher in the varus knees than in the valgus aligned knees (p=0.02). The medial metaphyseal ROI showed a decrease in BMD during the follow-up in preoperatively varus knee joints (p<0.001). In preoperatively valgus knees, there was a slight increase in medial compartment BMD which was not significant (p=0.2). Alignment correction in both groups showed bone remodeling giving similar medial and lateral BMD values, suggesting that the bone became equally strong in both compartments of the metaphysis. There was no association between increasing American Knee Society (AKS) scores and bone remodeling.

Interpretation: We suggest that this remodeling is caused by postoperative changes in tibial loading. Our results support the clinical importance of recreating proper valgus alignment of the knee joint in the TKA operation, thus possibly providing better conditions for longevity of the tibial component.

全膝关节置换术后69例患者假体周围胫骨骨密度变化:1年随访研究。
背景:全膝关节置换术(TKA)中支撑假体构件的关键结构是胫骨小梁骨。胫骨的质量可以通过骨矿物质密度(BMD)测量来评估。患者和方法:我们前瞻性地测量了骨关节膝关节骨水泥TKA后胫骨近端骨密度的变化。69例患者分别于术后1周、3、6、12个月进行双能x线吸收仪(DXA)扫描。结果:在基线时,膝内翻组的内侧感兴趣区(ROI)骨密度高于膝外翻组(p=0.02)。在术前膝关节内翻的随访中,内侧干骺端ROI显示BMD下降(解释:我们认为这种重塑是由术后胫骨负荷的变化引起的。我们的研究结果支持在TKA手术中重建膝关节适当外翻排列的临床重要性,从而可能为胫骨部件的寿命提供更好的条件。
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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