Relationship between cement penetration and incidence of a radiolucent line around the tibia 2 years after total knee arthroplasty: A retrospective study

IF 2.7 Q1 ORTHOPEDICS Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2024-08-01 DOI:10.1016/j.jisako.2024.05.015

{"title":"Relationship between cement penetration and incidence of a radiolucent line around the tibia 2 years after total knee arthroplasty: A retrospective study","authors":"","doi":"10.1016/j.jisako.2024.05.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Cement penetration (CP) plays a key role in implant stability for cemented total knee arthroplasty (TKA), and the radiolucent line (RLL) >2 mm is a preliminary sign for loosening of components. However, the direct relationship between CP and the frequency of RLL >2 mm is unclear, and the best cut-off value for CP to prevent RLL >2 mm also remains unclear. This study aimed to investigate this relationship between CP and RLL and to determine the clinical cut-off value for tibial CP in patients 2 years after TKA.</p></div><div><h3>Methods</h3><p>This retrospective study investigated 157 knees from 123 patients with osteoarthritis who underwent cemented TKA. The CP and RLL immediately after TKA and the RLL 2 years after TKA were measured for the medial, lateral, anterior, and posterior tibial baseplate zones. Receiver operating characteristic (ROC) curves were constructed to determine the best cut-off values for CP.</p></div><div><h3>Results</h3><p>RLL >2 mm was not observed just after TKA. An RLL >2 mm was observed in any tibial baseplate zone in 22 knees from 20 patients (RLL+ group) and was not observed in the remaining (RLL− group) 2 years after TKA. The mean CP for all zones was significantly higher in the RLL− group (2.5 ± 1.1 mm) than in the RLL+ group (1.7 ± 0.6 mm; <em>P</em> < 0.001). An RLL >2 mm was seen in 21 knees in the medial zone, 9 knees in the lateral zone, 8 knees in the anterior zone, and 3 knees in the posterior zone. CP values with RLL >2 mm were significantly lower than those without the RLL at the medial, anterior, and posterior tibial baseplate zones. The best cut-off values from the ROC curve of CP in each zone were between 1.1 mm and 2.1 mm.</p></div><div><h3>Conclusions</h3><p>The depth of the CP directly affects the incidence of an RLL >2 mm. The best cut-off value for tibial CP to prevent an RLL >2 mm is 2.1 mm.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001020/pdfft?md5=671cba7defe8bd429226639c663662dd&pid=1-s2.0-S2059775424001020-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2059775424001020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Cement penetration (CP) plays a key role in implant stability for cemented total knee arthroplasty (TKA), and the radiolucent line (RLL) >2 mm is a preliminary sign for loosening of components. However, the direct relationship between CP and the frequency of RLL >2 mm is unclear, and the best cut-off value for CP to prevent RLL >2 mm also remains unclear. This study aimed to investigate this relationship between CP and RLL and to determine the clinical cut-off value for tibial CP in patients 2 years after TKA.

Methods

This retrospective study investigated 157 knees from 123 patients with osteoarthritis who underwent cemented TKA. The CP and RLL immediately after TKA and the RLL 2 years after TKA were measured for the medial, lateral, anterior, and posterior tibial baseplate zones. Receiver operating characteristic (ROC) curves were constructed to determine the best cut-off values for CP.

Results

RLL >2 mm was not observed just after TKA. An RLL >2 mm was observed in any tibial baseplate zone in 22 knees from 20 patients (RLL+ group) and was not observed in the remaining (RLL− group) 2 years after TKA. The mean CP for all zones was significantly higher in the RLL− group (2.5 ± 1.1 mm) than in the RLL+ group (1.7 ± 0.6 mm; P < 0.001). An RLL >2 mm was seen in 21 knees in the medial zone, 9 knees in the lateral zone, 8 knees in the anterior zone, and 3 knees in the posterior zone. CP values with RLL >2 mm were significantly lower than those without the RLL at the medial, anterior, and posterior tibial baseplate zones. The best cut-off values from the ROC curve of CP in each zone were between 1.1 mm and 2.1 mm.

Conclusions

The depth of the CP directly affects the incidence of an RLL >2 mm. The best cut-off value for tibial CP to prevent an RLL >2 mm is 2.1 mm.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

全膝关节置换术 2 年后骨水泥渗透与胫骨周围放射线发生率之间的关系：回顾性研究。

目的：骨水泥渗透（CP）对骨水泥全膝关节置换术（TKA）的植入物稳定性起着关键作用，而放射线（RLL）>2 毫米是组件松动的初步征兆。然而，CP 与 RLL >2 mm 频率之间的直接关系尚不清楚，防止 RLL >2 mm 的 CP 最佳临界值也仍不明确。本研究旨在探讨 CP 与 RLL 之间的关系，并确定 TKA 术后 2 年患者胫骨 CP 的临床临界值：这项回顾性研究调查了 123 名骨关节炎患者的 157 个膝关节，他们都接受了骨水泥 TKA。在 TKA 术后立即测量了 CP 和 RLL，在 TKA 术后 2 年测量了胫骨基底板内侧、外侧、前方和后方区域的 RLL。通过构建接收者操作特征曲线（ROC）来确定 CP 的最佳临界值：结果：TKA 术后未观察到 RLL >2 mm。在 20 名患者的 22 个膝关节中（RLL+ 组），任何胫骨基底板区都观察到 RLL >2 mm，其余患者（RLL- 组）在 TKA 术后 2 年未观察到 RLL >2 mm。RLL- 组所有区域的平均 CP 值（2.5 ± 1.1 mm）明显高于 RLL+ 组（1.7 ± 0.6 mm；21 个膝关节的内侧区域、9 个膝关节的外侧区域、8 个膝关节的前侧区域和 3 个膝关节的后侧区域出现了 P2 mm。在胫骨基底板内侧区、前区和后区，RLL >2 mm 的 CP 值明显低于无 RLL 的 CP 值。从 CP 的 ROC 曲线来看，每个区域的最佳临界值在 1.1 毫米和 2.1 毫米之间：结论：CP 深度直接影响 RLL >2 mm 的发生率。防止 RLL >2 mm 的胫骨 CP 最佳临界值为 2.1 mm。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊