Is cement mantle thickness a primary cause of aseptic tibial loosening following primary total knee arthroplasty?

Zach C. Cox, Stephen M Engstrom, A. Shinar, Gregory G. Polkowski, J. Mason, J. R. Martin
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引用次数: 1

Abstract

BACKGROUND Aseptic tibial loosening following primary total knee replacement is one of the leading causes of long-term failure. Cement mantle thickness has been implicated as a source of aseptic tibial loosening. Therefore, the following study was designed to determine (1) what is the cement mantle thickness in patients that develop aseptic tibial loosening, and (2) is there a difference in cement mantle thickness based on the interface of failure? METHOD This retrospective cohort included 216 patients revised for aseptic tibial loosening. Patient demographics, operative data, and clinical outcomes were recorded. A preoperative radiographic assessment was performed to determine the interface of failure and the thickness of the cement mantle using the Knee Society Radiographic Evaluation System zones. RESULTS The average patient age was 65 years and body mass index was 33.7 kg/m2. 203 patients demonstrated radiographic failure at the implant-cement interface and 13 patients demonstrated failure at the cement-bone interface. The average cement mantle thickness of each radiographic zone for the entire cohort on the AP and lateral views was 4.4 and 4.5 mm, respectively. The average cement mantle thickness of patients that developed failure at the implant-cement interface was significantly greater than patients that failed at the cement-bone interface in each radiographic zone (p < 0.001). CONCLUSIONS Patients that develop implant loosening at the cement-bone interface were noted to have a significantly decreased cement mantle compared to patients that failed at the implant-cement interface. Methods for decreasing tibial implant loosening should likely focus on improving the fixation at the implant-cement interface.
水泥膜厚度是初次全膝关节置换术后无菌性胫骨松动的主要原因吗?
背景:原发性全膝关节置换术后无菌性胫骨松动是导致长期手术失败的主要原因之一。骨水泥套厚度被认为是无菌性胫骨松动的一个原因。因此,下面的研究旨在确定(1)无菌性胫骨松动患者的水泥套厚度是多少,(2)基于失效界面的水泥套厚度是否存在差异?方法回顾性研究216例无菌性胫骨松动患者。记录患者人口统计、手术数据和临床结果。术前影像学评估使用膝关节学会影像学评估系统区确定失效界面和水泥套厚度。结果患者平均年龄65岁,体重指数33.7 kg/m2。203例患者在种植体-水泥界面表现出x线摄影失败,13例患者在水泥-骨界面表现出失败。整个队列在正位和侧位上每个x线摄影区域的平均水泥套厚度分别为4.4和4.5 mm。在每个x线成像区,在种植体-水泥界面发生失败的患者的平均水泥套厚度显著大于在水泥-骨界面发生失败的患者(p < 0.001)。结论:在骨水泥界面发生假体松动的患者与在骨水泥界面发生松动的患者相比,其骨水泥套明显减少。减少胫骨假体松动的方法应侧重于改善假体-骨水泥界面的固定。
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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