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Risk Factors for Physiologic Radiolucent Lines Under the Tibial Base Plate After Osteoarthritis With Primary Computer‐Assisted Navigation TKA—A Nested Case‐Control Study

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Název: Risk Factors for Physiologic Radiolucent Lines Under the Tibial Base Plate After Osteoarthritis With Primary Computer‐Assisted Navigation TKA—A Nested Case‐Control Study
Autoři: Hao Tian, Yang Ma, Jinrui Zhang, Enbo Liu, Zhuo Zhang, Jianlin Zuo
Zdroj: Orthopaedic Surgery, Vol 17, Iss 9, Pp 2717-2725 (2025)
Informace o vydavateli: Wiley, 2025.
Rok vydání: 2025
Sbírka: LCC:Orthopedic surgery
Témata: computer‐assisted navigation, osteoarthritis, radiolucent lines, risk factors, tibial implant, total knee arthroplasty, Orthopedic surgery, RD701-811
Popis: ABSTRACT Background Osteoarthritis (OA) is the most prevalent joint disease in the elderly population, and primary computer‐assisted navigation total knee arthroplasty (CA‐TKA) remains a critical therapeutic intervention for OA. The presence of physiologic radiolucent lines (RLLs) beneath the tibial base plate following CA‐TKA carries significant long‐term clinical implications and is regarded as a potential indicator of prosthetic loosening. However, the specific risk factors for RLL development in CA‐TKA, despite its theoretical precision advantages, remain poorly understood. This study aimed to characterize the clinical features of physiologic RLLs and identify associated risk factors. Methods A retrospective nested case‐control study was conducted using a cohort of OA patients who underwent primary CA‐TKA between January 2021 and September 2024. Physiologic RLLs were diagnosed according to the 1989 Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Patients with physiologic RLLs under the tibial base plate at follow‐up were assigned to the RLLs group, while controls were matched 1:1 from the cohort based on follow‐up time (±14 days). Covariates included age, gender, body mass index, smoking, alcohol consumption, hypertension, diabetes, surgical side, hospital stay duration, operative time, anesthesia type, continuous passive motion use, periprosthetic joint infection, total perioperative blood loss, preoperative/postoperative hip‐knee‐ankle angle (HKA), tibial cement mantle quality, cement penetration, and perioperative medial proximal tibial angle. Univariate and multivariate analyses were performed to identify risk factors. Results The cohort comprised 407 patients, of whom 113 developed physiologic RLLs under the tibial base plate. Univariate analysis identified age, preoperative HKA, tibial cement mantle defects, and cement penetration as statistically significant risk factors (all p
Druh dokumentu: article
Popis souboru: electronic resource
Jazyk: English
ISSN: 1757-7861
1757-7853
Relation: https://doaj.org/toc/1757-7853; https://doaj.org/toc/1757-7861
DOI: 10.1111/os.70134
Přístupová URL adresa: https://doaj.org/article/286f40b0202349e886dbebc9e11f0cc9
Přístupové číslo: edsdoj.286f40b0202349e886dbebc9e11f0cc9
Databáze: Directory of Open Access Journals
Popis
Abstrakt:ABSTRACT Background Osteoarthritis (OA) is the most prevalent joint disease in the elderly population, and primary computer‐assisted navigation total knee arthroplasty (CA‐TKA) remains a critical therapeutic intervention for OA. The presence of physiologic radiolucent lines (RLLs) beneath the tibial base plate following CA‐TKA carries significant long‐term clinical implications and is regarded as a potential indicator of prosthetic loosening. However, the specific risk factors for RLL development in CA‐TKA, despite its theoretical precision advantages, remain poorly understood. This study aimed to characterize the clinical features of physiologic RLLs and identify associated risk factors. Methods A retrospective nested case‐control study was conducted using a cohort of OA patients who underwent primary CA‐TKA between January 2021 and September 2024. Physiologic RLLs were diagnosed according to the 1989 Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Patients with physiologic RLLs under the tibial base plate at follow‐up were assigned to the RLLs group, while controls were matched 1:1 from the cohort based on follow‐up time (±14 days). Covariates included age, gender, body mass index, smoking, alcohol consumption, hypertension, diabetes, surgical side, hospital stay duration, operative time, anesthesia type, continuous passive motion use, periprosthetic joint infection, total perioperative blood loss, preoperative/postoperative hip‐knee‐ankle angle (HKA), tibial cement mantle quality, cement penetration, and perioperative medial proximal tibial angle. Univariate and multivariate analyses were performed to identify risk factors. Results The cohort comprised 407 patients, of whom 113 developed physiologic RLLs under the tibial base plate. Univariate analysis identified age, preoperative HKA, tibial cement mantle defects, and cement penetration as statistically significant risk factors (all p
ISSN:17577861
17577853
DOI:10.1111/os.70134