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MR Vol.10 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.10 No.2 |
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The relationship between postoperative results
and bone dynamics in RA patients who underwent cementless Ortholoc
II TKA: histomorphometric study |
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| O. Obayashi1, S. Sasaki1, S. Katsube2,
S. Uta1, K. Kaneko1, Y. Yanagihara1 |
(1)Department of Orthopedic Surgery, Juntendo
University School of Medicine, Tokyo, Japan
(2)Department of Orthopedic Surgery, Nakaizu Spa Hospital, Shizuoka, Japan |
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| Abstract |
| Abstract We previously reported a histomorphometric
study of iliac bone obtained at the time of cementless total knee
arthroplasty (TKA) in patients with rheumatoid arthritis (RA).
In this paper, we further extended our analysis to investigate
the postoperative results and radiographs after TKA in association
with bone metabolism. All the patients were female, ranging in
age from 38 to 68 years (mean, 56.8 years). Histomorphometric results
demonstrated that bone volume and trabecular thickness were decreased,
whereas bone absorption and bone formation rate (BFR) were increased.
The bone in patients with mutilating disease (MUD) showed remarkably
increased bone turnover and osteoporosis compared with those of
the more erosive subset (MES) patients. Sixteen out of the 20 patients
were alive at the time of follow-up (follow-up period between 5
years 10 months and 8 years 11 months). Among them, 10 patients
could be further examined. Radiolucent lines (RLL) were assessed
by the modified Knee Society evaluation (scoring) system. The number
of RLL (N-RLL) were correlated with BFR in morphometric examination.
In addition, the weight-bearing zones in the N-RLL were more significantly
correlated with BFR. The Japanese Orthopedic Association (JOA)
score and pain score negatively correlated with eroded bone surface.
The present study indicated that bone dynamics, rather than the
bone volume at the time of TKA, were involved in the presence of
RLL and in pain after surgery for TKA. |
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| Key words |
| Key words Rheumatoid arthritis ・ Osteoporosis
・ Histomorphometric study ・ Total knee arthroplasty ・ Radiolucent
line |
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