Comparison of cementless twin-peg, cemented twin-peg and cemented single-peg femoral component migration after medial unicompartmental knee replacement: a 5-year randomized RSA study,Archives of Orthopaedic and Trauma Surgery

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Comparison of cementless twin-peg, cemented twin-peg and cemented single-peg femoral component migration after medial unicompartmental knee replacement: a 5-year randomized RSA study
Archives of Orthopaedic and Trauma Surgery ( IF 2.0 ) Pub Date : 2023-08-11 , DOI: 10.1007/s00402-023-04991-y
Sebastian Breddam Mosegaard _{1,

2} , Anders Odgaard _{3,

4} , Frank Madsen ₁ , Lone Rømer ₅ , Per Wagner Kristensen ₆ , Tobias Dahl Vind _{1,

2,

7} , Kjeld Søballe _{1,

7} , Maiken Stilling _{1,

2,

7}

Affiliation

Background

The component design and fixation method of joint arthroplasty may affect component migration and survival. The aim of this study was to compare fixation of cementless twin-peg (CLTP), cemented twin-peg (CTP) and cemented single-peg (CSP) femoral components of medial unicompartmental knee replacement (UKR).

Methods

Eighty patients (mean age = 63 years, 48 males) with medial knee osteoarthritis were randomized in three ways to CLTP (n = 25), CTP (n = 26) or CSP (n = 29) femoral UKR components. The patients were followed 5 years postoperatively with RSA, bone mineral density (BMD), PROMs and radiological evaluation of radiolucent lines (RLL), femoral component flexion angle and complications.

Results

At the 5-year follow-up, femoral component total translation was comparable between the three groups (p = 0.60). Femoral component internal rotation was 0.50° (95% CI 0.3; 0.69) for the CLTP group, 0.58° (95% CI 0.38; 0.77) for the CTP group and 0.25° (95% CI 0.07; 0.43) for the CSP group (p = 0.01). BMD decreased peri-prosthetically (range − 11.5%; − 14.0%) until 6-month follow-up and increased toward the 5-year follow-up (range − 3.6%; − 5.8%). BMD change did not correlate with component migration. Lower flexion angle was correlated with higher 5-year subsidence, total translation, varus rotation and maximum total point motion (p = 0.01). Two patients (1 CLTP, 1 CTP) had RLL in the posterior zone. There were two revisions.

Conclusion

At 5-year follow-up, fixation of UKA femoral components with twin-peg was not superior to the single-peg design. Cementless and cemented twin-peg femoral components had similar fixation. A lower flexion angle was correlated with higher component migration.

中文翻译：

内侧单间室膝关节置换术后非骨水泥双钉、骨水泥双钉和骨水泥单钉股骨组件迁移的比较：一项为期 5 年的随机 RSA 研究

背景

关节置换术的组件设计和固定方法可能会影响组件的迁移和存活。本研究的目的是比较内侧单间室膝关节置换术 (UKR) 的非骨水泥双钉 (CLTP)、骨水泥双钉 (CTP) 和骨水泥单钉 (CSP) 股骨组件的固定。

方法

80 名患有内侧膝骨关节炎的患者（平均年龄 = 63 岁，48 名男性）被随机分配至 CLTP ( n = 25)、CTP ( n = 26) 或 CSP ( n = 29) 股骨 UKR 组件。术后对患者进行 5 年随访，包括 RSA、骨密度 (BMD)、PROM 以及射线可透线 (RLL)、股骨假体屈曲角度和并发症的放射学评估。

结果

在 5 年随访中，三组之间的股骨组件总平移具有可比性 ( p = 0.60)。CLTP 组的股骨假体内旋为 0.50° (95% CI 0.3; 0.69)，CTP 组为 0.58° (95% CI 0.38; 0.77)，CSP 组为 0.25° (95% CI 0.07; 0.43)。p = 0.01）。BMD 在 6 个月随访期间假体周围下降（范围 − 11.5%；− 14.0%），并在 5 年随访期间增加（范围 − 3.6%；− 5.8%）。BMD 变化与组件迁移无关。较低的屈曲角度与较高的 5 年下沉、总平移、内翻旋转和最大总点运动相关（p = 0.01）。两名患者（1 名 CLTP，1 名 CTP）后区有 RLL。有两次修订。