Relationship of the histomorphometric parameters to the development of sinking, loosening, and clear zone in total knee arthroplasty for rheumatoid arthritis.

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Nineteen patients of rheumatoid arthritis who had undergone total knee arthroplasty were followed up for clinical and radiological signs of sinking, loosening, and clear zone formation for an average period of 3 years, 10 months; ranging from 2 years, 4 months, to 5 years, 2 months. There were 2 males and 17 females. Their average age was 52.4 years, ranging from 30 to 75.<BR>The following histomorphometric studies were carried out on undecalcif ied specimens of the proxymal tibial metaphysis obtained at the time of arthroplasty: determination of the bone area, average trabecular width, psteoid surface, scalloped surface, and inert surface.<BR>Clinically and radiologically, there were no cases of sinking or loosening. There were 7 cases of clear zone formation out of the 19 patients. Histomorphometry of bone area and average trabecular width revealed that there were no significant differences between those with clear zone formation and those without it. However, the determinants of osteoid surface and scalloped surface appeared to be greater in the group with clear zone formation than in the other, and the opposite was true for the inert surface.<BR>Thus the parameters of bone remodeling at the time of arthroplasty for rheumatoid arthritis might be indicative of the future development of clear zone formation.
日本関節病学会の論文