Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Jacob T. Munro MBChB, Salil Pandit MBChB, Cameron G. Walker PhD, Mark Clatworthy MBChB, FRACS, Rocco P. Pitto MD, PhD, FRACS
Original Article
Volume 468, Issue 3 / March , 2009

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Abstract

Little is known about tibial bone remodeling with TKA and its clinical relevance. We performed a randomized clinical trial to compare tibial bone density changes in cemented components with different bearing designs. Bone density changes were assessed using quantitative computed tomography (qCT)-assisted osteodensitometry. Twenty-eight rotating-platform and 26 fixed-platform cemented TKAs were included. The nonoperated contralateral side was used as a control. CT scans were performed postoperatively and 1 year and 2 years after the index operation. Cancellous bone density loss (up to 12.6% at 2 years) was observed in all proximal tibial regions in both cohorts. In contrast, we found lower cortical bone density loss (up to 3.6% at 2 years). We found no differences in bone loss between fixed- and rotating-platform implants. The decrease of cancellous bone density after TKA suggests stress transfer to the cortical bone.

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