Low Rate of Peri-implant Osteolysis in Trabecular Metal Total Ankle Replacement on Short- to Midterm Follow-up
Low Rate of Peri-implant Osteolysis in Trabecular Metal Total Ankle Replacement on Short- to Midterm Follow-up
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DOI：
10.1177/10711007211017468
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发表时间：
2021-06-18
影响因子：
2.7
通讯作者：
Tiusanen, Hannu
中科院分区：
文献类型：
--
作者：
Kormi, Sami;Kohonen, Ia;Tiusanen, Hannu
背景：植入物周围骨溶解是全踝关节置换术的主要并发症之一。本研究的目的是使用计算机断层扫描（CT）作为骨小梁金属全踝关节（TMTA）植入物的成像方法，研究植入物周围骨质溶解的短期至中期发生率，该植入物代表一种新型全踝关节置换（TAR）植入物设计，涉及材料和手术技术。方法：本研究共纳入了104例在2013年3月至2017年10月期间接受初次TMTA置换术的连续患者。影像学评价包括基线和术后3个月、6个月和每12个月的负重前后位和侧位片。术前进行了螺旋CT检查，80例患者术后至少随访12个月，TAR手术与最新CT检查之间的平均时间间隔为39个月（范围：12-85）。结果：80例患者中8例在CT图像上共发现11个假体周围溶骨性病灶。胫骨7例，距骨3例，腓骨远端1例。4例胫骨病变位于内踝，未与假体部件接触。溶骨性病变的大小范围为7 - 20 mm，病变的平均体积为689 mm（3）。结论：我们得出结论，TMTA种植体的种植体周围骨溶解风险在短期至中期内最小。解剖结构、独特的材料和手术技术都可能导致TMTA植入物的植入物周围骨质溶解率较低。
Background: Peri-implant osteolysis is one of the major complications related to total ankle replacement. The aim of this study was to investigate the short- to midterm incidence of peri-implant osteolysis using computed tomography (CT) as imaging method for the Trabecular Metal Total Ankle (TMTA) implant representing a novel total ankle replacement (TAR) implant design regarding material and surgical technique. Methods: In total, 104 consecutive patients who had a primary TMTA replacement between March 2013 and October 2017 were included in the study. The radiographic evaluation included weightbearing anteroposterior and lateral views at baseline and after 3, 6, and every 12 months postoperatively. A helical CT was undertaken preoperatively and of the 80 patients available to follow up at least 12 months postoperatively, with average time interval between the TAR operation and the latest CT of 39 (range, 12-85) months. Results: Eight of 80 patients had altogether 11 osteolytic lesions around the components on CT images. Seven lesions were found in tibia, 3 in talus, and 1 in distal fibula. Four of the tibial lesions were situated in the medial malleolus and were not in contact with the prosthesis component. The sizes of the osteolytic lesions ranged between 7 and 20 mm, and the average volume of the lesions was 689 mm(3). Conclusion: We conclude that the risk of peri-implant osteolysis with the TMTA implant is minimal in short to midterm. The anatomic configuration, unique material, and surgical technique may all contribute to the TMTA implant having a low rate of peri-implant osteolysis.