PDF(Pubmed)
Abstract：
UNASSIGNED: Little is known about the relationship between implant material and periprosthetic bone mineral density (pBMD) in total knee arthroplasty (TKA). The purpose of this study was to investigate the change in pBMD after TKA and to compare pBMD changes between two different implant materials.
UNASSIGNED: A prospective matched-pair case-control study was conducted on 29 patients who underwent bilateral TKAs. The participants were randomly allocated to undergo cemented TKAs with a titanium nitride (TiN)-coated implant on one knee (TiN group) and a cobalt-chromium (CoCr) implant on the other knee (CoCr group). The pBMD was measured using dual-energy X-ray absorptiometry scans before surgery and at 1 and 2 years after surgery. The results were then compared between the two groups. The pBMDs at longer follow-ups (> 2 years) were estimated using simple radiographs (pBMDe).
UNASSIGNED: At 2 years after surgery, the pBMD significantly decreased in both groups at medial metaphysis of the tibia and anterior portion of the distal femur (all p < 0.001). The CoCr group showed a larger decrease in pBMD than did the TiN group in the medial and anterior metaphysis of the proximal tibia (p = 0.003 and p = 0.046, respectively). The pBMDe was significantly higher in the TiN group at the anterior portion of the distal femur 7 years after surgery (p = 0.019).
UNASSIGNED: The pBMD significantly decreased 2 years after TKA in certain regions regardless of the implant material used. However, the decrease was significantly less in the TiN group in specific regions of the tibia and femur. The TiN implant was beneficial in preserving the periprosthetic bone stock after TKA.
UNASSIGNED: A prospective matched-pair case-control study was conducted on 29 patients who underwent bilateral TKAs. The participants were randomly allocated to undergo cemented TKAs with a titanium nitride (TiN)-coated implant on one knee (TiN group) and a cobalt-chromium (CoCr) implant on the other knee (CoCr group). The pBMD was measured using dual-energy X-ray absorptiometry scans before surgery and at 1 and 2 years after surgery. The results were then compared between the two groups. The pBMDs at longer follow-ups (> 2 years) were estimated using simple radiographs (pBMDe).
UNASSIGNED: At 2 years after surgery, the pBMD significantly decreased in both groups at medial metaphysis of the tibia and anterior portion of the distal femur (all p < 0.001). The CoCr group showed a larger decrease in pBMD than did the TiN group in the medial and anterior metaphysis of the proximal tibia (p = 0.003 and p = 0.046, respectively). The pBMDe was significantly higher in the TiN group at the anterior portion of the distal femur 7 years after surgery (p = 0.019).
UNASSIGNED: The pBMD significantly decreased 2 years after TKA in certain regions regardless of the implant material used. However, the decrease was significantly less in the TiN group in specific regions of the tibia and femur. The TiN implant was beneficial in preserving the periprosthetic bone stock after TKA.
摘要：
■关于全膝关节置换术（TKA）中植入物材料与假体周围骨矿物质密度（pBMD）之间的关系知之甚少。目的研究TKA后pBMD的变化，并比较两种不同植入材料之间的pBMD变化。
■对29例接受双侧TKAs的患者进行了一项前瞻性配对病例对照研究。参与者被随机分配接受胶结的TKAs，其中一个膝盖上有氮化钛（TiN）涂层植入物（TiN组），另一个膝盖上有钴铬（CoCr）植入物（CoCr组）。手术前和手术后1年和2年使用双能X线骨密度仪扫描测量pBMD。然后比较两组的结果。使用简单的射线照片（pBMDe）估计较长随访（>2年）的pBMD。
■手术后2年，两组胫骨内侧干phy端和股骨远端前部的pBMD均显著降低(均p<0.001).与TiN组相比，CoCr组在胫骨近端内侧和前干phy端的pBMD下降幅度更大（分别为p=0.003和p=0.046）。手术后7年，TiN组股骨远端前部的pBMDe明显更高（p=0.019）。
■无论使用何种植入物材料，在TKA后2年，pBMD在某些区域均显着降低。然而,在胫骨和股骨的特定区域，TiN组的下降幅度明显较小。TiN植入物有利于在TKA后保留假体周围的骨原料。
■对29例接受双侧TKAs的患者进行了一项前瞻性配对病例对照研究。参与者被随机分配接受胶结的TKAs，其中一个膝盖上有氮化钛（TiN）涂层植入物（TiN组），另一个膝盖上有钴铬（CoCr）植入物（CoCr组）。手术前和手术后1年和2年使用双能X线骨密度仪扫描测量pBMD。然后比较两组的结果。使用简单的射线照片（pBMDe）估计较长随访（>2年）的pBMD。
■手术后2年，两组胫骨内侧干phy端和股骨远端前部的pBMD均显著降低(均p<0.001).与TiN组相比，CoCr组在胫骨近端内侧和前干phy端的pBMD下降幅度更大（分别为p=0.003和p=0.046）。手术后7年，TiN组股骨远端前部的pBMDe明显更高（p=0.019）。
■无论使用何种植入物材料，在TKA后2年，pBMD在某些区域均显着降低。然而,在胫骨和股骨的特定区域，TiN组的下降幅度明显较小。TiN植入物有利于在TKA后保留假体周围的骨原料。
