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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 5, 606-613.
doi: 10.1302/0301-620X.88B5.16893  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Peri-prosthetic bone mineral density after total knee arthroplasty

CEMENTED VERSUS CEMENTLESS FIXATION

R. B. Abu-Rajab, MBChB, MRCS, Orthopaedic Specialist Registrar1; W. S. Watson, BSc, PhD, FIPEM, FInstP, Consultant Clinical Scientist2; B. Walker, DCR, Medical Technical Officer2; J. Roberts, MBChB, FRCS(Tr & Orth), Orthopaedic Specialist Registrar1; S. J. Gallacher, MD, FRCP, Consultant Physician3; and R. M. D. Meek, MD, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon1

1 Orthopaedic Department
2 Nuclear Medicine Department
3 Diabetes Centre, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.

Correspondence should be sent to Mr R. B. Abu-Rajab, c/o Mr Meek’s secretary; e-mail: r1abu{at}hotmail.com

We compared peri-prosthetic bone mineral density between identical cemented and cementless LCS rotating platform total knee arthroplasties. Two matched cohorts had dual energy x-ray absorptiometry scans two years post-operatively using a modified validated densitometric analysis protocol, to assess peri-prosthetic bone mineral density. The knee that was not operated on was also scanned to enable the calculation of a relative bone mineral density difference. Oxford Knee and American Knee Society scores were comparable in the two cohorts.

Statistical analysis revealed no significant difference in absolute, or relative peri-prosthetic bone mineral density with respect to the method of fixation. However, the femoral peri-prosthetic bone mineral density and relative bone mineral density difference were significantly decreased, irrespective of the method of fixation, particularly in the anterior distal portion of the femur, with a mean reduction in relative bone mineral density difference of 27%.

There was no difference in clinical outcome between the cemented and cementless LCS total knee arthroplasty. However, both produce stress-shielding around the femoral implants. This leads us to question the use of more expensive cementless total knee components.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General