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

TY - JOUR

T1 - 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

AU - Andersen, Mikkel R.

AU - Winther, Nikkolaj S.

AU - Lind, Thomas

AU - Schrøder, Henrik M

AU - Flivik, Gunnar

AU - Petersen, Michael M.

PY - 2017/7

Y1 - 2017/7

N2 - 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.

AB - 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.

KW - BMD

KW - Cementless

KW - Migration

KW - RSA

KW - TKA

KW - Uncemented

U2 - 10.1016/j.arth.2017.02.032

DO - 10.1016/j.arth.2017.02.032

M3 - Journal article

C2 - 28410836

AN - SCOPUS:85017437987

SN - 0883-5403

VL - 32

SP - 2141

EP - 2146

JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

IS - 7

ER -