The associations of implant and patient factors with migration of the tibial component differ by sex: a radiostereometric study on more than 400 total knee arthroplasties. (1st April 2022)

• Record Type: Journal Article
• Authors: Laende, Elise K.; Mills Flemming, Joanna; Astephen Wilson, Janie L.; Cantoni, Eva; Dunbar, Michael J.
• Is Part Of: Bone & joint journal. Volume 104B:Number 4(2022)
• Page Start: 444
• Page End: 451
• Publication Date: 2022-04-01
• Subjects: Radiostereometric analysis -- Total knee arthroplasty -- Implant fixation -- tibial components -- radiostereometric analysis (RSA) -- total knee arthroplasty (TKA) -- BMI -- primary TKAs -- uncemented tibial components -- cemented implants -- knees -- standard deviation -- implant migration; Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; 617.47005
• DOI: 10.1302/0301-620X.104B4.BJJ-2021-1247.R1
• Languages: English
• ISSNs: 2049-4394

Abstract

Abstract : Aims: Thresholds of acceptable early migration of the components in total knee arthroplasty (TKA) have traditionally ignored the effects of patient and implant factors that may influence migration. The aim of this study was to determine which of these factors are associated with overall longitudinal migration of well-fixed tibial components following TKA. Methods: Radiostereometric analysis (RSA) data over a two-year period were available for 419 successful primary TKAs (267 cemented and 152 uncemented in 257 female and 162 male patients). Longitudinal analysis of data using marginal models was performed to examine the associations of patient factors (age, sex, BMI, smoking status) and implant factors (cemented or uncemented, the size of the implant) with maximum total point motion (MTPM) migration. Analyses were also performed on subgroups based on sex and fixation. Results: In the overall group, only fixation was significantly associated with migration (p < 0.001). For uncemented tibial components in males, smoking was significantly associated with lower migration (p = 0.030) and BMI approached significance (p = 0.061). For females with uncemented components, smoking (p = 0.081) and age (p = 0.063) approached significance and were both associated with increased migration. The small number of self-reported smokers in this study warrants cautious interpretation and further investigation. For cemented components in females, larger sizes of tibial component were significantly associated with increased migration (p = 0.004). No factors were significant for cemented components in males. Conclusion: The migration of uncemented tibial components was more sensitive to patient factors than cemented implants. These differences were not consistent by sex, suggesting that it may be of value to evaluate female and male patients separately following TKA. Cite this article: Bone Joint J 2022;104-B(4):444–451.