No changes in bone mineral density following total knee arthroplasty using an all polyethylene tibial component

5 pages•Published: October 26, 2019

Alistair Ewen, Jill Rae, Artaban Jeldi and Frederic Picard

Abstract

Polyethylene particles produced in metal backed tibias (MBT) are understood to contribute to bone loss and component loosening. This, and better surgical techniques (including computer navigation) and increasing costs have renewed interest in all poly tibias (APT). We investigated peri-APT bone mineral density (BMD) in patients; expecting to find no differences between two post-operative values.
Patients over 65 years, with BMI ≤ 37.5 and no previous joint replacements were recruited to have TKA using the Columbus APT with computer navigation (OrthoPilot). The study cohort (n=26) had a mean age of 71.9 (sd 4.35), a BMI of 31.2 (sd 3.8). The BMD examinations were performed six weeks and 18 months post-operatively. Six regions-of-interest (ROI) were identified on anterior/posterior and lateral scans. For each ROI at each time point, relative BMD differences (RDs) were determined between limbs and RDs at the two time points were compared.
No differences were found between the two RDs for any ROI. No revisions or complications were reported. At 18 months post-operatively, 78.3% of the cohort were “very satisfied” with the outcome of their surgery and Oxford Knee Scores improved significantly compared to pre-operatively (p<0.005). Mean knee range of motion was 102° (sd 10.7◦) and mean leg alignment was 2.0° valgus (1°varus-6°valgus).
Results from BMD suggest that implants were well fixated. Patients reported excellent satisfaction and function. We believe that using APTs and computer navigation is a viable and cheaper option to MBT for patients who are less active, have lower BMI and good bone quality.

Keyphrases: all polyethylene tibia, bone mineral density, total knee replacement

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 122-126.

Links:	https://easychair.org/publications/paper/VWq9
	https://doi.org/10.29007/kqnb

BibTeX entry

@inproceedings{CAOS2019:No_changes_bone_mineral,
  author    = {Alistair Ewen and Jill Rae and Artaban Jeldi and Frederic Picard},
  title     = {No changes in bone mineral density following total knee arthroplasty using an all polyethylene tibial component},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/VWq9},
  doi       = {10.29007/kqnb},
  pages     = {122-126},
  year      = {2019}}

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