Abstract
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.
Keywords
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Article Info
Publication History
Published online: October 24, 2019
Accepted:
October 15,
2019
Received in revised form:
October 10,
2019
Received:
August 29,
2019
Footnotes
Funding: This work was supported by the Health Research Foundation of Central Denmark Region [1-31-72-15-14].
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.10.027.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
