Subchondral bone condition and total knee arthroplasty in patients with knee osteoarthritis

Background: 6% of adults suffer from knee joint osteoarthritis. In some cases, the method of choice of treatment is knee arthroplasty. The etiology of osteoarthritis remains largely unclear, but the question of involving the subchondral bone in the pathological process is beyond doubt. One of the causes of pain and other adverse effects after knee replacement may be subchondral bone pathology of the femur and tibia.

Aims: To study the changes in the condyles of the tibia in osteoarthritis and to determine the possible impact of these changes on the development of instability of the knee joint endoprosthesis.

Methods: From December 2014 to February 2016, 56 patients were examined. They underwent total arthroplasty of the knee joint. The average age of the patients was 63 years (from 55 to 78 years). Women were 52 (93%), men - 4 (7%). A histological examination of the resected tibial condyles was carried out to reveal bone pathology.

Results: Typical changes for osteoarthritis were found microscopically. In all cases the signs of osteoporosis were present. A clear histological picture of osteomalacia in the non-calcinated bone was found in 15 women.

Conclusions: Having studied the subchondral bone in these patients we can conclude that the knee endoprosthesis is implanted into a weakened bone, which can lead to adverse effects. To improve the long-term results of surgical treatment, medical correction of bone tissue pathology in the perioperative period is suggested.

Osteoarthritis, knee arthroplasty, subchondral, osteoporosis, osteomalacia,

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