Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Orthopaedic Surgery, Shiraniwa Hospital, Ikoma, Nara, Japan.
J Arthroplasty. 2020 Nov;35(11):3156-3160. doi: 10.1016/j.arth.2020.06.014. Epub 2020 Jun 12.
Our previous study showed that the decrease in relative change of bone mineral density (BMD) in the lateral part of the tibia was significantly less in the group treated with the cementless porous tantalum component than in the group treated with the cemented cobalt-chromium tibial component up to 5 years after the operation. However, the long-term benefits of porous tantalum tibial component on BMD have not been proven. The aim of this study was to update a matched cohort study at a minimum of 6 years' follow-up period.
Twenty patients with a porous tantalum tibial component and 18 patients with a cemented cobalt-chromium-alloy tibial component were investigated for more than 6 years in the present study. The mean follow-up period was 11.4 years. Dual X-ray absorptiometry was used to measure the BMD.
The decrease in relative change of BMD in the lateral aspect of the tibia was significantly less with the porous tantalum tibial component than that with the cemented cobalt-chromium tibial component up to 5 years. However, at the final follow-up period, no significant difference was observed in the relative change of BMD between the 2 groups. No prosthetic migration or periprosthetic fracture was detected in either group.
The present study is one of the studies with the longest follow-up period on BMD after total knee arthroplasty. Porous tantalum tibial component did not have a favorable effect on the BMD of the proximal tibia after total knee arthroplasty for long term.
我们之前的研究表明,在术后 5 年内,与使用水泥固定钴铬合金胫骨组件的患者相比,使用非水泥固定多孔钽组件的患者胫骨外侧骨密度(BMD)的相对变化减少程度明显较小。然而,多孔钽胫骨组件对 BMD 的长期益处尚未得到证实。本研究的目的是在至少 6 年的随访期内更新一项匹配队列研究。
本研究对 20 例使用多孔钽胫骨组件和 18 例使用水泥固定钴铬合金胫骨组件的患者进行了超过 6 年的随访。平均随访时间为 11.4 年。使用双能 X 线吸收法测量 BMD。
在术后 5 年内,与使用水泥固定钴铬合金胫骨组件的患者相比,使用多孔钽胫骨组件的患者胫骨外侧 BMD 的相对变化减少程度明显较小。然而,在最终随访时,两组间 BMD 的相对变化无显著差异。两组均未发现假体迁移或假体周围骨折。
本研究是全膝关节置换术后 BMD 随访时间最长的研究之一。多孔钽胫骨组件对全膝关节置换术后胫骨近端 BMD 无长期有利影响。