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Radiolucent lines below the tibial component of a total knee replacement (TKR) – a comparison between single-and two-stage cementation techniques

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Abstract

Early non-progressive horizontal radiolucent lines (RLLs) (<2 mm) under the tibial component following cemented total knee replacement (TKR) are considered to result from poor cement injection into cancellous bone. These RLLs may facilitate the entry of joint fluid and wear debris into the interface, which may proceed to ballooning osteolysis. There is currently no consensus on the preferred cementing technique (single- versus two-stage cementation) in TKR. We have prospectively analysed postoperative radiographs in 50 consecutive TKRs to compare the RLLs following single- (25 TKRs) and two-stage (25 TKRs) cementation techniques. Of the TKR radiographs studied, 26 (52%) had RLLs; nine (36%) of these were single-stage TKRs, and 17 (68%) were two-stage TKRs. This study demonstrates that single-stage cementing may be superior to the two-stage technique in terms of avoiding RLLs in immediate postoperative TKRs.

Résumé

Après prothèse du genou, un liseré (RLLs) (<2 mm) apparaît de façon très fréquente, précoce, et non évolutive, sous le plateau tibial. Celui-ci est probablement secondaire à une mauvaise pénétration du ciment à l’intérieur du tissu spongieux. Ces liserés facilitent la pénétration du liquide articulaire et des débris d’usure au niveau de l’interface et peuvent être responsables d’ostéolyses. Il n’y a pas de consensus actuellement sur la technique de cimentage (cimentation en un temps ou en deux temps). Nous avons analysé de façon prospective les radiographies de 50 prothèses totales du genou consécutives en comparant les liserés (RLLs) après cimentage en un temps ou en deux temps. 26 (52%) des prothèses totales du genou avaient un liseré, 9/25 (36%) présentaient un liseré inférieur à 2 mm dans les cimentages en un temps, 17/25 (68%) un liseré dans les cimentages en deux temps. Cette étude montre de façon claire que le cimentage en un temps est supérieur à la technique du cimentage en deux temps et évite les liserés immédiats post-opératoires.

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Authors and Affiliations

  1. Department of Orthopaedics, Wrexham Maelor Hospital, Wrexham, UK

    Abhijit Ranjan Guha, Ujjwal Kanti Debnath & Niall McKenzie Graham

  2. Department of Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK

    Niall McKenzie Graham

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  1. Abhijit Ranjan Guha
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  2. Ujjwal Kanti Debnath
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  3. Niall McKenzie Graham
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Correspondence to Abhijit Ranjan Guha.

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Guha, A.R., Debnath, U.K. & Graham, N.M. Radiolucent lines below the tibial component of a total knee replacement (TKR) – a comparison between single-and two-stage cementation techniques. International Orthopaedics (SICO 32, 453–457 (2008). https://doi.org/10.1007/s00264-007-0345-6

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  • DOI: https://doi.org/10.1007/s00264-007-0345-6

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