Experimental study of bone tissue density in monocondylar knee arthroplasty according to preliminary CT data and its intraoperative determination

Authors

  • V.O. Movchanyuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • P.M. Zhuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • O.D. Karpinska State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • M.Yu. Karpinsky State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • S.I. Sukhorukov Vinnytsia National Technical University, Vinnytsia, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.1.23.2022.877

Keywords:

bone tissue, density, tibial plateau, arthroplasty

Abstract

Background. One of the main complications in monocondylar arthroplasty of the knee joint is the instability of the components of the endoprosthesis. When planning the operation, it is necessary to take into account the bone mineral density to prevent negative consequences in the postoperative period, such as aseptic and septic processes in the area of the implantation component. The purpose was to conduct a comparative analysis of the results of studying the characteristics of bone density according to computed tomography and the proposed device. Materials and methods. To solve this problem, a study of the bone density of the tibial sawdust area was carried out using a measuring device. To compare the results, a study of bone density in the area of interest of the tibia was performed using CT images of the knee joint on a scale of Hounsfield units in nine zones. Two groups of 10 patients were studied: group I — patients in whom, according to densitometry, osteopenia was determined (T-score from –1.0 to –2.5) and group II — patients, in which densitometry T-score was less than –2.5. Results. It was found that the maximum optical density of the cortical layer in group I patients was 678 ± 150 HU, in group II patients — 377 ± 93 HU, the elastic modulus was 1435 ± 363 MPa, the difference in the absorption of the cortical layer between the groups was statistically significant (t = 2.509; p = 0.046). In central zones 1–3, the tissue absorption index is higher in patients of group I. On the marginal zones 4, 6–8, the level of bone tissue absorption in both groups of patients is almost the same. The modulus of elasticity of the cancellous tissue of the tibia in the sawdust area during endoprosthesis does not statistically differ from the calculated values, although it shows fewer data. This is due to the structure of the cancellous tissue, which has thin bone plates and crossbars (trabeculae), which intersect with each other and form many cells. The place where the spongy tissue stiffness is measured is highly likely to fall into the intertrabecular space, although the size of the indenter is larger, therefore, bone structures are also involved in the measurements. Conclusions. Modern methods of medical imaging, including CT, provide not only accurate data on changes in bone tissue structures but also the ability to determine the physical properties of tissues — optical absorption of bone structures, geometric dimensions, etc. However, tomographic studies are still quite valuable today, so more affordable ways to determine the physical data of the bone are being developed. The developed method and device for measuring bone density makes it possible to quickly and objectively determine the quality of the bone in the resection area. But in some cases, in patients with low bone density, there is a need for additional preoperative CT examinations.

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References

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Published

2022-05-16

How to Cite

Movchanyuk, V., Zhuk, P., Karpinska, O., Karpinsky, M., & Sukhorukov, S. (2022). Experimental study of bone tissue density in monocondylar knee arthroplasty according to preliminary CT data and its intraoperative determination. TRAUMA, 23(1), 12–18. https://doi.org/10.22141/1608-1706.1.23.2022.877

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Section

Original Researches

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