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KMID : 0359619960080010042
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Journal of Korean Knee Society
1996 Volume.8 No. 1 p.42 ~ p.53
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Radiological Analysis of Cementless Total Knee Arthroplasty (Comparative Studies in Osteoarthritis and Rheumatoid Arthritis)
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Abstract
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Although long term studies of the total knee arthroplasty have confirmed reliable relief of pain and maintenance of function, the late loosening of the component being the most serious complication. So we analzed the radilogical results of the
total
knee arthroplasty performed in osteoathritis and rheumatoid arhritis.
The cementless total knee arthroplasty was performed in 48 osteoarthritis knees and 28 rheumatoid arthritis knees from Feburary 1987 to December 1992. The clinical and radiological analysis were performed between two groups using the American
Knee
Society roentgenographic evaluation and Hospital for Special Surgery knee score system. The follow up period was ranged from 36 months to 96 months (average 50 months). The clinical results including knee scores and rage of motion were similar in
both
groups. The imporovement of range of motion and flexion contracture after total knee arthroplasty was remarkable in rheumatoid arthritis group.
There was no significant differences in radiological results between the osteoarthritis and the rheumatoid arthritis. In rheumatoid arthritis(81%) the radiolucent lines were more frequently observed than in ostcoarthritis(73%), but the appearance
of the
lines was earlier in osteoarthritis(6 month) than in rheumatoid arthritis(8 month), The radiolucent lines showed higher frequency in zone 4 on the femoral side in both groups. On the tibial side the osteoarthritis showed higher frequency in zone
4
and
the rheumatoid arthritis in zone 1. The radiolucent lines were found more frequenhtly on the tibial side(76%) than the femoral side(51%).
In conclusion, there was no significant difference in clinical and radiological results between the osteoarthritis and the rheumatoid arthritis group after cementless fixation method. Even in the patient with the poor bone stock like rheumatoid
arthritis, there seems to be no relations of the bone ingrowth between the component. And incomplete radiolucent lines may be of minor clinical importance, bit progressive and continuous lines suggest potential loosening should be considered be
considered carefully.
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