Особливості мінеральної щільності великогомілкової кістки на рівні її опилу при монокондилярній артропластиці колінного суглоба

Abstract

The article presents the results of measuring the bone mineral density at the level of the tibial saw cut during monocondylar arthroplasty of the knee joint using a device developed by the authors. Objective of the study - to determine the dependence of the level of bone mineral density on the thickness of the bone saw cut, the zone of its determination, the age and sex of the patients. 178 patients (147 women and 31 men) aged 50 to 79 years were examined. Mostly medial arthrosis occurred in 189, lateral - in 12 cases. In the process of carrying out monocondylar arthroplasty of the knee joint (201 joints) the mineral density of the bone tissue was determined depending on the thickness of the resection of the tibia. Slice thickness 9, 11, 13 mm. Significant discrepancies in bone mineralization of the tibia were revealed. The densest are the anterior sections of the saw cut, the least dense are the central and posterior-lateral ones. With age and thickness of the saw cut, the indicators proportionally decrease in the same relationship, and after 70 years of patients in most cases it is less than 50% of the norm. Moreover, men have higher rates of bone mineralization than women of the same age. The uneven distribution of the mineral density of the tibial bone tissue, the presence of weakly mineralized areas in the central and posterolateral sections of the saw cut, a proportional decrease in bone density in the elderly allowed us to develop a method for preventively increasing the reliability of fixation and stability of the tibial component of the endoprosthesis. This approach allowed us to review the age limits for monocondylar arthroplasty and get good long-term results.