Predictors of early aseptic loosening of prosthetic components following primary total knee arthroplasty

Mikhail B. Gurazhev; Гуражев Михаил Борисович; Vitaliy L. Lukinov; Лукинов Виталий Леонидович; Vladislav S. Baitov; Баитов Владислав Сергеевич; Anton S. Gofer; Гофер Гофер Сергеевич; Evgeniy A. Ivanov; Иванов Евгений Александрович; Vitaliy V. Pavlov; Павлов Виталий Викторович; Andrey A. Korytkin; Корыткин Андрей Александрович; Aleksandr A. Pronskikh; Пронских Александр Андреевич

doi:10.17816/2311-2905-17595

Predictors of early aseptic loosening of prosthetic components following primary total knee arthroplasty

作者: Gurazhev M.B.¹, Lukinov V.L.¹, Baitov V.S.¹, Gofer A.S.¹, Ivanov E.A.¹, Pavlov V.V.¹, Korytkin A.A.¹, Pronskikh A.A.¹
隶属关系:
1. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
期: 卷 31, 编号 3 (2025)
页面: 35-49
栏目: Clinical studies
URL: https://journal-vniispk.ru/2311-2905/article/view/326959
DOI: https://doi.org/10.17816/2311-2905-17595
ID: 326959

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Background. Aseptic loosening of the knee prosthesis components is one of the most common causes of revision surgery. The acceptable range of angular values for postoperative alignment of the lower limb and the frontal positioning of the prosthetic components remains a subject of debate.

The aim of the study — to identify the predictors of the early aseptic loosening of prosthetic components following primary total knee arthroplasty.

Methods. The study group included 31 patients with aseptic loosening of prosthetic components. The comparison group consisted of 55 patients with no signs of loosening over a follow-up period of at least 8 years. Baseline characteristics (sex, age, body mass index, and operated side) were compared, along with preoperative and postoperative angular alignment of the lower limbs, specifically, the anatomical femorotibial angle (aFTA) and the hip-knee-ankle angle (HKA), as well as reference angles for prosthetic component positioning.

Results. Patient age over 60.5 years and BMI over 27.5 were associated with a 2.9-fold and 2.6-fold increased risk of prosthetic loosening, respectively. Preoperative varus deformity, with an HKA angle exceeding 9.5° and an aFTA over 6.5°, increased the risk of loosening by 9.6 and 23.1 times, respectively. Postoperative residual deformity exceeding 0.5° in either direction, as measured by the aFTA, increased the risk of loosening by 8.7 times. Valgus positioning of the tibial component was associated with a 2.8-fold increased risk of component loosening.

Conclusions. In elderly and overweight patients with pronounced varus deformity of the lower limb, personalized preoperative planning should be prioritized to prevent early aseptic loosening of prosthetic components. In cases where postoperative residual deformity or valgus positioning of the tibial component is detected, enhanced clinical follow-up with radiographic monitoring every 6 months is recommended. If radiolucent lines progress and pain is present, early consideration of revision surgery is advisable, as it may increase the likelihood of a successful conservative revision.

关键词

total knee arthroplasty, aseptic loosening of prosthetic components, revision knee arthroplasty, lower limb alignment, preoperative planning

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作者简介

Mikhail Gurazhev

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: Tashtagol@inbox.ru
ORCID iD: 0000-0002-6398-9413
俄罗斯联邦, Novosibirsk

Vitaliy Lukinov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: vitaliy.lukinov@gmail.com
ORCID iD: 0000-0002-3411-508X

Cand. Sci. (Phys.-Math.)

俄罗斯联邦, Novosibirsk

Vladislav Baitov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: VBaitov@list.ru
ORCID iD: 0000-0002-9427-7072

Cand. Sci. (Med.)

俄罗斯联邦, Novosibirsk

Dr. Sci. (Med.), Associate Professor

俄罗斯联邦, Novosibirsk

Andrey Korytkin

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: andrey.korytkin@gmail.com
ORCID iD: 0000-0001-9231-5891

Cand. Sci. (Med.)

俄罗斯联邦, Novosibirsk

Aleksandr Pronskikh

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: proal_88@mail.ru
ORCID iD: 0000-0003-1197-556X
Scopus 作者 ID: 6503950260

Dr. Sci. (Med.)

俄罗斯联邦, Novosibirsk

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