Preoperative proximal tibial bone density, bone microarchitecture, and bone turnover are not associated with postoperative tibial component migration in cemented and cementless medial unicompartmental knee replacements: secondary analyses from a randomized controlled trial
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Preoperative proximal tibial bone density, bone microarchitecture, and bone turnover are not associated with postoperative tibial component migration in cemented and cementless medial unicompartmental knee replacements : secondary analyses from a randomized controlled trial. / Bendtsen, Mathias Alrø Fichtner; Odgaard, Anders; Madsen, Frank; Mosegaard, Sebastian Breddam; Thomsen, Jesper Skovhus; Hauge, Ellen Margrethe; Søballe, Kjeld; Stilling, Maiken.
In: Acta Orthopaedica, Vol. 95, 2024, p. 121-129.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Preoperative proximal tibial bone density, bone microarchitecture, and bone turnover are not associated with postoperative tibial component migration in cemented and cementless medial unicompartmental knee replacements
T2 - secondary analyses from a randomized controlled trial
AU - Bendtsen, Mathias Alrø Fichtner
AU - Odgaard, Anders
AU - Madsen, Frank
AU - Mosegaard, Sebastian Breddam
AU - Thomsen, Jesper Skovhus
AU - Hauge, Ellen Margrethe
AU - Søballe, Kjeld
AU - Stilling, Maiken
N1 - Publisher Copyright: © 2024 The Author(s). Published by MJS Publishing – Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation.
PY - 2024
Y1 - 2024
N2 - Background and purpose — Cementless arthroplasty fixation relies on early bone ingrowth and may be poor in patients with low proximal tibial bone density or abnormal bone turnover. We aimed first to describe the baseline bone properties in patients undergoing medial unicompartmen-tal knee replacement (UKR), and second to investigate its association with cemented and cementless tibial component migration until 2 years. Methods — A subset investigation of 2 patient groups from a 3-armed randomized controlled trial was conducted. There were 26 cemented and 25 cementless medial UKRs with twin-pegged femoral components. Volumetric bone mineral density (vBMD) and microstructure of the excised medial tibial plateau were ascertained with µCT. Bone turnover was estimated using dynamic histomorphometry (eroded surface/bone surface = ES/BS, osteoid surface/bone surface = OS/BS, mineralizing surface/bone surface = MS/ BS). Tibial component migration in 4 feature points was followed for 2 years with radiostereometry. Results — At the 2-year follow-up, the cementless tibial components migrated 0.38 mm (95% confidence interval [CI] 0.14–0.62) total translation more than the cemented components at the posterior feature point. The greatest migration in the cementless group was subsidence at the posterior feature point of 0.66 mm (CI 0.48–0.84) until 6 weeks, and from 3 months the components were stable. Cemented tibial components subsided very little. Between 1-and 2-year follow-ups, no cementless but 4 cemented tibial components revealed continuous migration. OS/BS was half of the ES/BS. No µCT or histomorpho-metric parameters showed any clinically relevant correlation with tibial component migration at the posterior feature point for either cemented or cementless UKR at 6 weeks’ or 2 years’ follow-up after adjustment for age, BMI, and sex. Conclusion — Preoperative vBMD, bone turnover, and microstructure were not associated with postoperative tibial component migration of cemented and cementless medial UKR.
AB - Background and purpose — Cementless arthroplasty fixation relies on early bone ingrowth and may be poor in patients with low proximal tibial bone density or abnormal bone turnover. We aimed first to describe the baseline bone properties in patients undergoing medial unicompartmen-tal knee replacement (UKR), and second to investigate its association with cemented and cementless tibial component migration until 2 years. Methods — A subset investigation of 2 patient groups from a 3-armed randomized controlled trial was conducted. There were 26 cemented and 25 cementless medial UKRs with twin-pegged femoral components. Volumetric bone mineral density (vBMD) and microstructure of the excised medial tibial plateau were ascertained with µCT. Bone turnover was estimated using dynamic histomorphometry (eroded surface/bone surface = ES/BS, osteoid surface/bone surface = OS/BS, mineralizing surface/bone surface = MS/ BS). Tibial component migration in 4 feature points was followed for 2 years with radiostereometry. Results — At the 2-year follow-up, the cementless tibial components migrated 0.38 mm (95% confidence interval [CI] 0.14–0.62) total translation more than the cemented components at the posterior feature point. The greatest migration in the cementless group was subsidence at the posterior feature point of 0.66 mm (CI 0.48–0.84) until 6 weeks, and from 3 months the components were stable. Cemented tibial components subsided very little. Between 1-and 2-year follow-ups, no cementless but 4 cemented tibial components revealed continuous migration. OS/BS was half of the ES/BS. No µCT or histomorpho-metric parameters showed any clinically relevant correlation with tibial component migration at the posterior feature point for either cemented or cementless UKR at 6 weeks’ or 2 years’ follow-up after adjustment for age, BMI, and sex. Conclusion — Preoperative vBMD, bone turnover, and microstructure were not associated with postoperative tibial component migration of cemented and cementless medial UKR.
U2 - 10.2340/17453674.2024.39917
DO - 10.2340/17453674.2024.39917
M3 - Journal article
C2 - 38391197
AN - SCOPUS:85185971150
VL - 95
SP - 121
EP - 129
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
ER -
ID: 385231729