Tibial tray thickness does not significantly increase medial tibial bone resorption: Using tibial bone density as an objective measurement method

Recent studies have reported the occurrence of medial tibial bone resorption following total knee replacement. One study proposed that a thick tibial tray results in stress shielding and increases the risk of bone resorption, but its findings were based on subjective radiological assessment. This st...

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Bibliographic Details
Published in:The knee 2020-03, Vol.27 (2), p.572-579
Main Authors: Wong, Daniel Wai-yip, Lee, Qunn-jid, Lo, Chi-kin, Wong, Yiu-chung, Law, Kenneth Wing-kin, Li, Alwin Hok-yin
Format: Article
Language:English
Subjects:
Body mass index
Bone density
Bone implants
Bone loss
Bone resorption
Chromium
Clinical outcomes
Cobalt
Densitometry
Digital radiological densitometry
Knee
Radiography
Range of motion
Stress shielding
Studies
Tibial bone density
Tibial tray thickness
Total knee replacement
Transplants & implants
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Summary:Recent studies have reported the occurrence of medial tibial bone resorption following total knee replacement. One study proposed that a thick tibial tray results in stress shielding and increases the risk of bone resorption, but its findings were based on subjective radiological assessment. This study aimed to verify this hypothesis and to objectively quantify medial tibial bone density by using serial measurements with digital radiological densitometry. This was a retrospective cohort study involving 140 patients (70 thick tray vs. 70 thin tray) with cobalt–chromium implants with at least 24 months of follow-up. Standard radiographs were reviewed to look for incidence of medial tibial bone loss. Serial measurement of medial tibial bone density was also performed using the method of digital radiological densitometry. There was no significant difference in the incidence of medial tibial bone loss. Both groups showed a significant drop in medial tibial bone density after operation (P 
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2019.12.011