Journal of orthopaedic surgery and research · 2025
Cement and screw reconstruction for Rand type II bone defects during total knee arthroplasty: a retrospective clinical and radiographic evaluation.
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Wang Tihui, Xu Hongwei, Wu Jinqing, Wang Xu
Аннотация
OBJECTIVE: To investigate the clinical and radiographic results of cement and screw reconstruction for bone defects during total knee arthroplasty(TKA).
METHODS: From September 2014 to September 2019, 38 patients with Rand type II bone defects who underwent the screw plus cement technique during primary TKA were included in this study. The clinical results were evaluated via the Knee Society Knee Scale (KSKS), Knee Society Function Scale (KSFS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM). The hip-knee-ankle angle (HKAA), femorotibial angle (FTA), and radiolucent lines were assessed radiologically.
RESULTS: Thirty-five patients were followed up for an average of 92.6 months (60-120 months). At the last follow-up visit, the KSKS, KSFS, WOMAC score, and ROM were significantly improved. The HKAA and FTA were corrected postoperatively. In 3 patients, a nonprogressive radiolucent line measuring approximately 1 mm was observed at the interface between the host bone and the cement at 3, 6 and 12 months after surgery, with an incidence of 8.3%, No radiolucent lines were found around the screws and no infection, fracture or prosthesis loosening occurred at the last follow-up visit.
CONCLUSION: Cement and screw reconstruction for Rand type II bone defects during TKA achieved satisfactory clinical and radiological results and solid fixation. This could be considered an economical and practical method to repair mild and moderate bone defects in primary TKA patients.
METHODS: From September 2014 to September 2019, 38 patients with Rand type II bone defects who underwent the screw plus cement technique during primary TKA were included in this study. The clinical results were evaluated via the Knee Society Knee Scale (KSKS), Knee Society Function Scale (KSFS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM). The hip-knee-ankle angle (HKAA), femorotibial angle (FTA), and radiolucent lines were assessed radiologically.
RESULTS: Thirty-five patients were followed up for an average of 92.6 months (60-120 months). At the last follow-up visit, the KSKS, KSFS, WOMAC score, and ROM were significantly improved. The HKAA and FTA were corrected postoperatively. In 3 patients, a nonprogressive radiolucent line measuring approximately 1 mm was observed at the interface between the host bone and the cement at 3, 6 and 12 months after surgery, with an incidence of 8.3%, No radiolucent lines were found around the screws and no infection, fracture or prosthesis loosening occurred at the last follow-up visit.
CONCLUSION: Cement and screw reconstruction for Rand type II bone defects during TKA achieved satisfactory clinical and radiological results and solid fixation. This could be considered an economical and practical method to repair mild and moderate bone defects in primary TKA patients.