Mittelfristige radiologische Ergebnisse nach bikondylärem ungekoppeltem Kniegelenkersatz mit Femurkomponenten aus Zirkonium und Chrom-Kobalt

Zusammenfassung

Studienziel: Ziel der Arbeit ist es, die mittelfristigen radiologischen Ergebnisse unterschiedlicher Femurkomponenten aus Zirkonium und Chrom-Kobalt eines designgleichen Kniegelenkersatzes darzustellen. Methode: Durchschnittlich 4 Jahre postoperativ wurden 31 Patienten mit einer Genesis-II-Knieendoprothese mit oberflächenkeramisierter Femurkomponente aus einer Zirkonium-Niob-Legierung und 32 Kniegelenke mit Standardfemurkomponenten aus einer Kobalt-Chrom-Legierung klinisch und radiologisch nach dem Roentgenographic Evaluation and Scoring System der Knee Society ausgewertet. Ergebnisse: Bei korrekter Implantatlage fanden sich statistisch signifikant häufiger Säume beim Gelenkersatz mit der oberflächenkeramisierten Femurkomponente in den Zonen 1 und 4 des Tibiaimplantates. Schlussfolgerungen: Die Ergebnisse stehen denen biomechanischer Studien des gleichen Prothesentyps am Kniesimulator entgegen, in denen der Abrieb in der Zirkoniumoxid-Gruppe um 85 % im Vergleich zur CoCr-Gruppe reduziert werden konnte. Eine Erklärung für die hohe Zahl bislang allerdings klinisch nicht relevanter Säume, könnte die Beobachtung sein, dass Zirkoniumionen die Mineralisierung von vorhandenem Osteoid im angrenzenden Interface durch negativen Einfluss auf die Entwicklung und Funktion von Matrixvesikeln hemmen.

Abstract

Aim: The present work aimed at evaluating the radiological mid-term results of femoral components of different materials in an identically designed total knee system. Method: 31 knees with zirconium femoral components and 32 standard femoral components were evaluated about 4 years following surgery using the Roentgenographic Evaluation and Scoring System of the Knee Society. Results: In both groups, the implant position was correct. There was a statistically significant higher rate of radiolucent lines in zones 1 and 4 at the tibia site in the zirconium group. Conclusion: Our clinical results disagree with the results of biomechanical studies of the same type of prosthesis. However, there are some findings from animal studies showing that zirconium ions may inhibit the mineralisation of osteoid, which could be an explanation for the higher rate of radiolucent lines seen in the present study.

Knie‐TEP - Zirkoniumoxid - Saumbildung

total knee arthroplasty - zirconium - radiolucent line

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