A multimodal assessment of cementless tibial baseplate fixation using radiography, radiostereometric analysis, and magnetic resonance imaging

Fixation in cementless total knee arthroplasty is provided by osseous integration. Radiography, radiostereometric analysis (RSA), and magnetic resonance imaging (MRI) were used simultaneously to investigate fixation. Relationships between RSA‐measured implant micromotions and MRI‐evaluated osseous i...

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Veröffentlicht in:Journal of orthopaedic research Jg. 42; H. 1; S. 100 - 108
Hauptverfasser: Broberg, Jordan S., Koff, Matthew F., Howard, James L., Lanting, Brent A., Potter, Hollis G., Teeter, Matthew G.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.01.2024
Schlagworte:
cementless fixation
Humans
Knee Joint - diagnostic imaging
Knee Joint - surgery
Knee Prosthesis
Magnetic Resonance Imaging
Osteoarthritis, Knee - diagnostic imaging
Prosthesis Design
Prosthesis Failure
Radiography
radiostereometric analysis
Radiostereometric Analysis - methods
total knee arthroplasty
cementless fixation
total knee arthroplasty
magnetic resonance imaging
radiostereometric analysis
radiography
ISSN:0736-0266, 1554-527X, 1554-527X
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Zusammenfassung:Fixation in cementless total knee arthroplasty is provided by osseous integration. Radiography, radiostereometric analysis (RSA), and magnetic resonance imaging (MRI) were used simultaneously to investigate fixation. Relationships between RSA‐measured implant micromotions and MRI‐evaluated osseous integration at the component–bone interface were assessed in 10 patients up to 6 months postoperation. Supine MRI (using multispectral imaging sequences) and RSA exams were performed to evaluate osseous integration and measure longitudinal migration, respectively. Inducible displacement was measured from standing RSA exams. Radiolucent lines were detected on conventional radiographs. Of 10 patients, 6 had fibrous membranes detected on MRI. No fluid or osteolytic interfaces were found, and no components were scored loose. Of 10 patients, 6 had radiolucent lines detected. Average maximum total point motion (MTPM) for longitudinal migration at 6 months was 0.816 mm (range 0.344–1.462 mm). Average MTPM for inducible displacement at 6 months was 1.083 mm (range 0.553–1.780 mm). Fictive points located in fibrous‐classified baseplate quadrants had greater longitudinal migration than fictive points located in baseplate quadrants with normal interfaces at 2 weeks (p = 0.031), 6 weeks (p = 0.046), and 3 months (p = 0.047), and greater inducible displacements at 3 months (p = 0.011) and 6 months (p = 0.045). Greater early micromotion may be associated with the presence of fibrous membranes at the component–bone interface. Clinical significance: This multimodal imaging study contributes knowledge of the fixation of modern cementless TKA, supporting the notion that osseous integration is important for optimal implant fixation.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0736-0266
1554-527X
1554-527X
DOI:10.1002/jor.25662