Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Seidel, M.
The Occurrence of Radiolucent Lines (RLL) after Uncemented Total Knee Arthroplasty – A Retrospective Long-Term Analysis.
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 83
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hauer Georg
- Sadoghi Patrick
- Altmetrics:
- Abstract:
- Background: Total knee arthroplasty is today the most common type of joint arthroplasty after total hip arthroplasty. Even if most of these total knee arthroplasties are still anchored in the bone using bone cement, bone cement-free surgical procedures are also an option, especially for younger patients. Previous publications could point out, that radiolucency lines (RLL) after cementless implantation often occur immediately postoperative and near the tibial component of the prothesis. However, on the one hand there are very few studies with meaningful case numbers and on the other hand there are hardly any publications with corresponding long-term observations of these RLL. So far, no significant statements have been made about the prognostic value of RLL in relation to aseptic loosening after cementless knee arthroplasty. Methods: Altogether we evaluated the x-ray images of 197 patients (mean age 70.0 years, SD= 2,84 Years, 65 males and 123 females, 11 revision patients) operated in 2005 and 2006 at the LKH Südsteiermark Bad Radkersburg who were treated with a uncemented Advanced Coated System (Impantcast, Buxtehude, DE) prothesis. As measuring time points, we chose postoperative, 6 weeks (46.9 days, SD=12,70 days), 1-2 Years (507 days, SD= 179,22 days) and 10 Years (119.9 month, SD= 15,74 month). The evaluation was made by a single observer using the ‘’Knee Society total knee arthroplasty roentgenographic evaluation and scoring system’’ published in 1989 by Ewald FC.. Therefor the RLL were classified after their point of occurrence (TAPZ1-7, TLT1-3, FLP1-7), their size and their progression over time. Results: We can confirm that most RLL are visible postoperative or that they build up within the first 6 weeks near the tibial component of the prothesis (TAPZ1-4). Most of those RLL form back during the time and very few persist for longer than 10 years. We also could show that the regression probability is higher for RLL near the femoral component of the prothesis. In this area not a single RLL could be detected after the 10 years follow up. Conclusion: The occurrence of RLL after uncemented TKA is very common but there is a high potential of spontaneous regression over time. The results indicate that RLL themselves do not affect the stability of an uncemented ACS Prothesis and therefore their prognostic value might be limited.