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Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty.
MedLine Citation:
PMID:  23325112     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Bone mineral density (BMD) in the proximal tibia decreases after TKA and is believed to be a factor in implant migration and loosening. Unicompartmental knee arthroplasty (UKA) is a less invasive procedure preserving knee compartments unaffected by degeneration. Finite element studies have suggested UKA may preserve BMD and that implants of differing stiffnesses might differentially affect BMD but these notions have not been clinically confirmed. QUESTIONS/PURPOSES: We therefore asked whether (1) proximal tibial BMD decreases after UKA, and (2) a cemented metal tibial component with a mobile polyethylene (PE) bearing would have greater BMD loss than a cemented PE tibial component. METHODS: We prospectively followed 48 patients who underwent 50 UKAs using one of two implants: one with a cemented metal tibial baseplate and a mobile PE insert (n = 26) and one with a cemented all-PE tibial component (n = 24). In followup we assessed pain and function (Oxford Knee Score, SF-12, The Knee Society Score(©)) and radiographs. BMD changes were assessed using quantitative CT osteodensitometry performed postoperatively and at 1 and 2 years after the index procedure. RESULTS: Mean cancellous BMD decreased 1.9% on the medial side and 1.1% on the lateral side. Mean cortical BMD was static, decreasing 0.4% on the medial side and increasing 0.5% on the lateral side. The greatest observed difference between implants for any region was 3.7%. There were no differences in pain or functional outcome scores. CONCLUSIONS: BMD was preserved 2 years after UKA with no major differences seen between implant types.
Authors:
Bradley I Richmond; Simon V Hadlow; Tim G Lynskey; Cameron G Walker; Jacob T Munro
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopaedics, Middlemore Hospital, Auckland, Manukau, 1640, New Zealand, bradleyr@windowslive.com.
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