胫骨定量CT骨密度测量法预测膝关节假体松动的研究

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Abstract Objective To investigate the effect of quantitative CT bone mineral density measurement of tibia on the prediction of knee prosthesis loosening.Methods A retrospective analysis was performed on 102 patients who underwent knee arthroplasty in the Department of Orthopaedicss of the 63650 Army Hospital of the People’s Liberation Army from January 2019 to January 2021.45 males and 57 females were included.The average age range was (68.90±7.67)years，ranging from 57 to 78 years.There were 40 cases of left knee and 62 cases of right knee.The body mass index (BMI)ranged from 21.26 to 30.01 kg/m²，with an average of (26.35±3.64)kg/m².The 102 patients were divided into the loose group and the non-loose group according to whether the prosthesis was loose or not.The bone mineral density of femur and proximal tibia was measured by dualenergy X-ray absorptiometry(DXA)and quantitative computed tomography (QCT)during preoperative and postoperative follow-up.Osteoporosis was diagnosed according to T value.The general data of the two groups of patients were analyzed，and the difference of bone mineral density between the two groups before surgery was observed.Reliability analysis was used to observe the internal and intermeasurement consistency of QCT detection.The changes of bone mineral density before and after operation were observed，and the diagnostic accuracy of DXA and QCT were analyzed.Results All patients were followed up for 12~24 months，with an average of (12.53±2.28)months.The number of osteoporosis cases in all patients after TKA was significantly increased.The results of QCT and DXA before TKA showed that the osteoporosis in the loose group was significantly higher than that in the non-loose group (P＜0.05).The diagnosis rate of tibia and proximal femur with QCT before and after operation was higher than that with DXA (P＜0.05).The observer consistency evaluation showed that the measurement results of different observers were highly consistent and the overall subjective error was small.Conclusion QCT bone mineral density measurement is accurate and reliable.The measurement of bone mineral density of proximal tibia before total knee arthroplasty can predict the prosthesis loosening to some extent.

Key words： osteoporosis quantitative computed tomography total knee arthroplasty prosthesis loosening

Corresponding Authors: Liu Bin

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	Deng Gang
	Wang Zhishan
	Song Wei
	Qin Xiaofeng
	Lv Delin
	Zhai Kun
	Liu Bin

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Deng Gang,Wang Zhishan,Song Wei, et al. Quantitative CT Bone Density Measurement of Tibia to Predict Knee Prosthesis Looseness[J]. sygkzz, 2023, 29(12): 1090-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I12/1090

［1］Postler A，Lützner C，Beyer F，et al.Analysis of total knee arthroplasty revision causes［J］.BMC Musculoskelet Disord，2018，19(1)：55.
［2］Solarino G，Piconi C，De Santis V，et al.Ceramic total knee arthroplasty：Ready to go?［J］.Joints，2017，5(4)：224-228.
［3］Choi KY，Lee SW，In Y，et al.Dual-energy CTbased bone mineral density has practical value for osteoporosis screening around the knee［J］.Medicina (Kaunas)，2022，58(8)：1085.
［4］Petersen MM，Nielsen PT，Lebech A，et al.Preoperative bone mineral density of the proximal tibia and migration of the tibial component after uncemented total knee arthroplasty［J］.J Arthroplasty，1999，14(1)：77-81.
［5］Ulivieri FM，Rinaudo L.Beyond bone mineral density：A new dual X-ray absorptiometry index of bone strength to predict fragility fractures，the bone strain index［J］.Front Med (Lausanne)，2021(7)：590139.
［6］张羽，张宗军，刘许慧，等.胸椎定量CT和腰椎双能X线吸收检测仪对绝经后女性骨质疏松症的诊断差异［J］.放射学实践，2022，37(10)：1205-1210.
［7］崔小巍，崔晓榕，袁涛.腰椎定量CT与双能X线骨密度检测对骨质疏松症的诊断价值比较［J］.临床和实验医学杂志，2020，19(16)：1785-1788.
［8］Viceconti M，Qasim M，Bhattacharya P，et al.Are CT-based finite element model predictions of femoral bone strength clinically useful?［J］.Curr Osteoporos Rep，2018，16(3)：216-223.
［9］基成跃，赵翔，夏建忠，等.双能X线吸收测定法和定量CT对老年患者骨质疏松诊断性能的比较［J］.影像研究与医学应用，2021，5(24)：104-106.
［10］中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018 年版)［J］.中华骨科杂志，2018，38(12)：705-715.
［11］任志帅，江泽华，张学利，等.重度膝关节骨性关节炎患者首次全膝关节置换术后髋部骨密度变化及其影响因素［J］.山东医药，2019，59(21)：64-66.
［12］International committee for standards in bone measurement.Standardization of proximal femur bone mineral density(BMD) measurements by DXA［J］.Bone，1997，21(4)：369-370.
［13］李佳录，嵇辉，陈星佐，等.定量CT测量膝关节骨密度的重复性研究［J］.中国骨质疏松杂志，2012，18(11)：988-991.
［14］Harvey NC，Biver E，Kaufman JM，et al.The role of calcium supplementation in healthy musculoskeletal ageing：An expert consensus meeting of the european society for clinical and economic aspects of osteoporosis，osteoarthritis and musculoskeletal diseases (ESCEO)and the international foundation for osteoporosis (IOF)［J］.Osteoporos Int，2017，28(2)：447-462.
［15］R-der C，Eggli S，ELKerdi A，et al.The intemational documentation and evaluation system(IDES) 10years experience［J］.Int Orthop，2003，27(5)：259-261.
［16］Nijholt W，Scafoglieri A，JagerWittenaar H，et al.The reliability and validity of ultrasound to quantify muscles in older adults：A systematic review［J］.J Cachexia Sarcopenia Muscle，2017，8(5)：702-712.
［17］Sadoghi P，Liebensteiner M，Agreiter M，et al.Revision surgery after total joint arthroplasty：A complication-based analysis using worldwide arthroplasty registers［J］.J Arthroplasty，2013(28)：1329-1332.
［18］Schroer WC，Berend KR，Lombardi AV，et al.Why are total knees failing today?Etiology of total knee revision in 2010 and 2011［J］.J Arthroplasty，2013，28(8 suppl)：116-119.
［19］田芳，朱宝.双能X线骨密度测定在全髋关节置换术后的应用进展［J］.中华核医学杂志，2011，31(4)：284-286.
［20］孙杰，卜国云，张金利.骨质疏松性胫骨平台骨折的治疗进展［J］.天津医药，2018，46(8)：894-899.
［21］Apostu D，Lucaciu O，Berce C，et al.Current methods of preventing aseptic loosening and improving osseointegration of titanium implants in cementless total hip arthroplasty：A review［J］.J Int Med Res，2018，46(6)：2104-2119.
［22］Labuda A，Papaioannou A，Pritchard J，et al.Prevalence of osteoporosis in osteoarthritic patients undergoing total hip or total knee arthroplasty［J］.Arch Phys Med Rehabil，2008，89(12)：2373-2374.