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。

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

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引用次数: 0

摘要

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。

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

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.