Abu-Rajab R B, Watson W S, Walker B, Roberts J, Gallacher S J, Meek R M D
Orthopaedic Department, Diabetes Centre, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK.
J Bone Joint Surg Br. 2006 May;88(5):606-13. doi: 10.1302/0301-620X.88B5.16893.
We compared peri-prosthetic bone mineral density between identical cemented and cementless LCS rotating platform total knee arthroplasties. Two matched cohorts had dual energy x-ray absorptiometry scans two years post-operatively using a modified validated densitometric analysis protocol, to assess peri-prosthetic bone mineral density. The knee that was not operated on was also scanned to enable the calculation of a relative bone mineral density difference. Oxford Knee and American Knee Society scores were comparable in the two cohorts. Statistical analysis revealed no significant difference in absolute, or relative peri-prosthetic bone mineral density with respect to the method of fixation. However, the femoral peri-prosthetic bone mineral density and relative bone mineral density difference were significantly decreased, irrespective of the method of fixation, particularly in the anterior distal portion of the femur, with a mean reduction in relative bone mineral density difference of 27%. There was no difference in clinical outcome between the cemented and cementless LCS total knee arthroplasty. However, both produce stress-shielding around the femoral implants. This leads us to question the use of more expensive cementless total knee components.
我们比较了相同的骨水泥型和非骨水泥型LCS旋转平台全膝关节置换术周围假体周围骨密度。两个匹配队列在术后两年使用改良的经验证的骨密度分析方案进行双能X线吸收测定扫描，以评估假体周围骨密度。对未手术的膝关节也进行扫描，以便计算相对骨密度差异。两个队列的牛津膝关节评分和美国膝关节协会评分相当。统计分析显示，就固定方法而言，绝对或相对假体周围骨密度无显著差异。然而，无论固定方法如何，股骨假体周围骨密度和相对骨密度差异均显著降低，尤其是在股骨远端前部，相对骨密度差异平均降低27%。骨水泥型和非骨水泥型LCS全膝关节置换术的临床结果无差异。然而，两者都会在股骨植入物周围产生应力遮挡。这使我们对使用更昂贵的非骨水泥型全膝关节组件产生质疑。
