Saari Tuuli, Uvehammer Johan, Carlsson Lons, Regnér Lons, Kärrholm Johan
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University, S-413 45 Göteborg, Sweden.
J Orthop Res. 2007 Jun;25(6):798-803. doi: 10.1002/jor.20358.
After total knee replacement (TKR) the bone mineral density (BMD) decreases in the proximal tibia. Our aim was to evaluate if changes in constraint of the cemented AMK TKR (DePuy, Johnson & Johnson, Leeds, UK) had any effect on postoperative bone remodeling in the proximal tibia. We used dual-energy X-ray absorptiometry in 43-53 knees to record changes in BMD in three regions of interest around the tibial component up to 5 years after operation with the AMK (DePuy) TKR. The knees had been randomly allocated to receive a flat or a concave tibial insert with retention of the posterior cruciate ligament when preoperative deformity was less severe, and either a concave or a posterior-stabilized (PS) insert with resection of the posterior cruciate ligament when deformity was more pronounced. All designs were associated with loss of BMD in the proximal tibia. The mean bone loss varied from 5 to 23% depending on the region of interest. There were no statistically significant differences between the groups, and the alteration of tibial insert constraint did not influence the bone remodeling. However, low precision values may have impaired the detection of differences.
全膝关节置换术（TKR）后，胫骨近端的骨矿物质密度（BMD）会降低。我们的目的是评估骨水泥型AMK TKR（英国利兹市强生公司DePuy产品）的限制变化是否对胫骨近端的术后骨重塑有任何影响。我们使用双能X线吸收法对43至53个膝关节进行检测，记录使用AMK（DePuy）TKR术后长达5年时间里，胫骨假体周围三个感兴趣区域的BMD变化情况。术前畸形不太严重时，膝关节被随机分配接受保留后交叉韧带的平面或凹面胫骨衬垫；畸形更明显时，则接受切除后交叉韧带的凹面或后稳定（PS）衬垫。所有设计均与胫骨近端BMD的降低有关。根据感兴趣区域的不同，平均骨丢失率在5%至23%之间。各组之间没有统计学上的显著差异，并且胫骨衬垫限制的改变并未影响骨重塑。然而，低精度值可能会影响差异的检测。
