Risk Factors for Physiologic Radiolucent Lines Under the Tibial Base Plate After Osteoarthritis With Primary...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Osteoarthritis (OA) is a leading cause of disability in the elderly.
• Computer-assisted navigation total knee arthroplasty (CA-TKA) is a key treatment for OA.
• Physiologic radiolucent lines (RLLs) under the tibial base plate post-CA-TKA may indicate prosthetic loosening, but risk factors are unclear.

Purpose of the Study:

• To characterize the clinical features of physiologic RLLs after CA-TKA.
• To identify independent risk factors associated with RLL development in CA-TKA.

Main Methods:

• Retrospective nested case-control study of 407 OA patients undergoing primary CA-TKA.
• Patients with RLLs were matched 1:1 with controls based on follow-up time.
• Multivariate logistic regression analyzed risk factors including HKA, cement mantle quality, and cement penetration.

Main Results:

• 113 patients developed physiologic RLLs.
• Preoperative hip-knee-ankle angle (HKA), tibial cement mantle defects, and cement penetration were independent risk factors.
• Age was not found to be an independent risk factor.

Conclusions:

• Physiologic RLL incidence post-CA-TKA is similar to conventional TKA.
• Preoperative HKA, cement mantle defects, and cement penetration are key predictors of RLLs.
• Understanding these factors can help mitigate RLL development and potential prosthetic loosening.