Advanced

Low Preoperative BMD Is Related to High Migration of Tibia Components in Uncemented TKA-92 Patients in a Combined DEXA and RSA Study With 2-Year Follow-Up

Andersen, Mikkel Rathsach; Winther, Nikkolaj S.; Lind, Thomas; Schrøder, Henrik M.; Flivik, Gunnar LU and Petersen, Michael (2017) In Journal of Arthroplasty 32(7). p.2141-2146
Abstract

Background: The fixation of uncemented tibia components in total knee arthroplasty may rely on the bone quality of the tibia; however, no previous studies have shown convincing objective proof of this. Component migration is relevant as it has been shown to predict aseptic loosening. Methods: We performed 2-year follow-up of 92 patients who underwent total knee arthroplasty surgery with an uncemented tibia component.Bone mineral density (BMD; g/cm2) of the tibia host bone was measured preoperatively using dual energy X-ray absorptiometry. The proximal tibia was divided into 2 regions of interest (ROI) in the part of the tibia bone where the components were implanted.Radiostereometric analysis was performed postoperatively and... (More)

Background: The fixation of uncemented tibia components in total knee arthroplasty may rely on the bone quality of the tibia; however, no previous studies have shown convincing objective proof of this. Component migration is relevant as it has been shown to predict aseptic loosening. Methods: We performed 2-year follow-up of 92 patients who underwent total knee arthroplasty surgery with an uncemented tibia component.Bone mineral density (BMD; g/cm2) of the tibia host bone was measured preoperatively using dual energy X-ray absorptiometry. The proximal tibia was divided into 2 regions of interest (ROI) in the part of the tibia bone where the components were implanted.Radiostereometric analysis was performed postoperatively and after 3, 6, 12, and 24 months. The primary outcome was maximum total point motion (MTPM; mm).Regression analysis was performed to evaluate the relation between preoperative BMD and MTPM. Results: We found low preoperative BMD in ROI1 to be significantly related to high MTPM at all follow-ups: after 3 months (R2 = 20%, PBMD = 0.017), 6 months (R2 = 29%, PBMD = 0.003), 12 months (R2 = 33%, PBMD = 0.001), and 24 months (R2 = 27%, PBMD = 0.001). We also found a significant relation for low BMD in ROI2 and high MTPM: 3 months (R2 = 19%, PBMD = 0.042), 6 months (R2 = 28%, PBMD = 0.04), 12 months (R2 = 32%, PBMD = 0.004), and 24 months (R2 = 24%, PBMD = 0.005). Conclusion: Low preoperative BMD in the tibia is related to high MTPM. Thus, high migration of uncemented tibia components is to be expected in patients with poor bone quality.

(Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
BMD, Cementless, Migration, RSA, TKA, Uncemented
in
Journal of Arthroplasty
volume
32
issue
7
pages
2141 - 2146
publisher
Elsevier
external identifiers
  • scopus:85017437987
ISSN
0883-5403
DOI
10.1016/j.arth.2017.02.032
language
English
LU publication?
no
id
014b27b4-3a94-42d3-a6be-19975461c3c7
date added to LUP
2017-05-02 13:44:37
date last changed
2018-01-31 11:17:19
@article{014b27b4-3a94-42d3-a6be-19975461c3c7,
  abstract     = {<p>Background: The fixation of uncemented tibia components in total knee arthroplasty may rely on the bone quality of the tibia; however, no previous studies have shown convincing objective proof of this. Component migration is relevant as it has been shown to predict aseptic loosening. Methods: We performed 2-year follow-up of 92 patients who underwent total knee arthroplasty surgery with an uncemented tibia component.Bone mineral density (BMD; g/cm<sup>2</sup>) of the tibia host bone was measured preoperatively using dual energy X-ray absorptiometry. The proximal tibia was divided into 2 regions of interest (ROI) in the part of the tibia bone where the components were implanted.Radiostereometric analysis was performed postoperatively and after 3, 6, 12, and 24 months. The primary outcome was maximum total point motion (MTPM; mm).Regression analysis was performed to evaluate the relation between preoperative BMD and MTPM. Results: We found low preoperative BMD in ROI1 to be significantly related to high MTPM at all follow-ups: after 3 months (R<sup>2</sup> = 20%, P<sub>BMD</sub> = 0.017), 6 months (R<sup>2</sup> = 29%, P<sub>BMD</sub> = 0.003), 12 months (R<sup>2</sup> = 33%, P<sub>BMD</sub> = 0.001), and 24 months (R<sup>2</sup> = 27%, P<sub>BMD</sub> = 0.001). We also found a significant relation for low BMD in ROI2 and high MTPM: 3 months (R<sup>2</sup> = 19%, P<sub>BMD</sub> = 0.042), 6 months (R<sup>2</sup> = 28%, P<sub>BMD</sub> = 0.04), 12 months (R<sup>2</sup> = 32%, P<sub>BMD</sub> = 0.004), and 24 months (R<sup>2</sup> = 24%, P<sub>BMD</sub> = 0.005). Conclusion: Low preoperative BMD in the tibia is related to high MTPM. Thus, high migration of uncemented tibia components is to be expected in patients with poor bone quality.</p>},
  author       = {Andersen, Mikkel Rathsach and Winther, Nikkolaj S. and Lind, Thomas and Schrøder, Henrik M. and Flivik, Gunnar and Petersen, Michael},
  issn         = {0883-5403},
  keyword      = {BMD,Cementless,Migration,RSA,TKA,Uncemented},
  language     = {eng},
  number       = {7},
  pages        = {2141--2146},
  publisher    = {Elsevier},
  series       = {Journal of Arthroplasty},
  title        = {Low Preoperative BMD Is Related to High Migration of Tibia Components in Uncemented TKA-92 Patients in a Combined DEXA and RSA Study With 2-Year Follow-Up},
  url          = {http://dx.doi.org/10.1016/j.arth.2017.02.032},
  volume       = {32},
  year         = {2017},
}