Bone Mineral Density in the Proximal Femur and Contralateral Knee After Total Knee Arthroplasty

Soininvaara, Tarja; Miettinen, Hannu; Jurvelin, Jukka S.; Alhava, Esko; Kröger, Heikki

doi:10.1385/jcd:7:4:424

Cited by 30 publications

(36 citation statements)

References 28 publications

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“…Furthermore, they observed a significant increase in BMD over time, also in the lumbar spine and in the contralateral hip. This contrasts with the findings of Soininvaara et al (2004) who showed no recovery of BMD in any hip or in the contralateral knee after total knee arthroplasty despite good functional recovery. Another discrepancy between our study and that of Karachalios et al (2004) is the mean age of the patients, which was 18 years more in the latter study.…”

Section: Discussioncontrasting

confidence: 99%

Continuous bone loss around a tapered uncemented femoral stem: A long-term evaluation with DEXA

et al. 2006

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Background Periprosthetic bone loss is a well-documented phenomenon after uncemented total hip arthroplasty (THA); however, little is known about how bone mineral density (BMD) changes after 2 years.Patients and methods 14 patients with hip arthrosis (group A) were operated with a proximally porous-and hydroxyapatite-coated stem and followed for 10 years with DEXA, radiographs and Harris hip score (HHS). Another group of 14 patients (group B) was evaluated at 6 and 14 years using the same prosthesis and protocol.Results No stem was revised and all stems were wellfixed. At final follow-up, HHS was 97 points in group A after 10 years and 94 points in group B after 14 years. Bone mineral changes in group A were greatest in Gruen zones 1 and 7, where the losses were 31% and 26%, respectively, after 2 years on the operated side. The decrease in BMD continued after 2 years and in Gruen zone 7 it was faster than the rate of bone loss on the control side. In group B, the annual change in BMD on the operated side was not significantly different from the bone loss in group A.Interpretation Up to 14 years after implantation of a tapered uncemented stem, the BMD in the calcar region continues to decrease faster than would be expected from normal ageing.

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Section: Discussioncontrasting

confidence: 99%

Continuous bone loss around a tapered uncemented femoral stem: A long-term evaluation with DEXA

et al. 2006

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“…The same effect occurred in valgus knees. Studies with controls [5,6,9,20] have found no evidence of BMD change either in the contralateral knee or spine after TKA. This implies a local effect attributable to the implant and changes in mechanical alignment as opposed to a global BMD change.…”

Section: Discussionmentioning

confidence: 99%

“…Dual-energy xray absorptiometry (DEXA) studies suggest proximal tibial BMD declines after TKA [1,5,9,12,17,[19][20][21]. However, it is not clear whether there are differences in BMD changes between cortical and cancellous bone.…”

Section: Introductionmentioning

confidence: 99%

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Munro

Pandit

Walker

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Little is known about tibial bone remodeling with TKA and its clinical relevance. We performed a randomized clinical trial to compare tibial bone density changes in cemented components with different bearing designs. Bone density changes were assessed using quantitative computed tomography (qCT)-assisted osteodensitometry. Twenty-eight rotating-platform and 26 fixed-platform cemented TKAs were included. The nonoperated contralateral side was used as a control. CT scans were performed postoperatively and 1 year and 2 years after the index operation. Cancellous bone density loss (up to 12.6% at 2 years) was observed in all proximal tibial regions in both cohorts. In contrast, we found lower cortical bone density loss (up to 3.6% at 2 years). We found no differences in bone loss between fixed-and rotating-platform implants. The decrease of cancellous bone density after TKA suggests stress transfer to the cortical bone.

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“…Bone density is expressed as grams of mineral per volume. BMD can give a good indication of bone quality and its change with time [41]. Using CT scan and our softwares, values of BMD are available, rapidly and easy done, and reliable in noninvasively determining BMD ( Figure 32).…”

Section: Bone Mineral Density Measurement 441 Theory Of the Bmdmentioning

confidence: 99%

“…Using CT scan and our softwares, values of BMD are available, rapidly and easy done, and reliable in noninvasively determining BMD ( Figure 32). Although many studies have evaluated the BMD after total joint arthroplasty [41], most of them mainly considered periprosthetic BMD to check loosening of the components [40]. In this section a method to evaluate it is reported in order to obtain BMD for healthy and operated femurs in patients.…”

Section: Bone Mineral Density Measurement 441 Theory Of the Bmdmentioning

confidence: 99%

Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

Izzo

2012

Eur J Transl Myol

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For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the pressfitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of force reaction have been accomplished to support surgeons during the prosthesis fitting. Identification of risk factors for fracture will improve preoperative counseling and aid primary prevention. To assess eventual improvements or find out trends respecting the implant used, gait data have been collected and compared with muscles mass modeling.

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Bone Mineral Density in the Proximal Femur and Contralateral Knee After Total Knee Arthroplasty

Cited by 30 publications

References 28 publications

Continuous bone loss around a tapered uncemented femoral stem: A long-term evaluation with DEXA

Continuous bone loss around a tapered uncemented femoral stem: A long-term evaluation with DEXA

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

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