Bones, blood and steel: How bioelectrical impedance analysis is affected by hip fracture and surgical implants

Abstract

Introduction Bioelectrical impedance analysis (BIA) is in widespread use, but there is uncertainty about its validity in patients with metal implants or after acute hip fracture and surgery. We aimed to investigate the use of single frequency tetrapolar BIA in patients with hip fracture by answering the following questions: 1) Are BIA measurements affected by recent hip fracture and surgical repair? 2) Are BIA measurements affected by the presence of metal implants used in hip fracture surgery? Setting Two hospitals in Bergen, Norway. Participants A convenience sample of 203 acute hip fracture patients. Methods Participants had their body composition measured by single frequency, tetrapolar BIA on the fractured and unfractured side of the body in the immediate postoperative period and at follow-up three months after hip fracture. Measurements from fractured and unfractured side and measurements in hospital and at follow-up were compared. BIA readings for hips treated with cannulated screws, compression hip screw and hip arthroplasty were compared. Results Resistance was lower on the side of the fractured hip compared to the unfractured side postoperatively, but not at follow-up. BIA readings did not differ by type of surgical implant. Conclusion Recent fracture and surgery influences single frequency tetrapolar BIA resistance. The presence of surgical implants in the hip do not affect BIA measurements. If BIA is used in acute hip fracture patients, the contralateral side to the fracture should be measured.

Case study: Effect of surgical metal implant on single frequency bioelectrical impedance measures of an athlete

“…Additionally, they commented that the BIA reading did not differ across the type of implant (cannulated screws, compression screw, or hip arthroplasty). Given the contradictory findings from Steihaug, Bogen, Kristoffersen, and Ranhoff (2017) with the present case study, more research is warranted with a range of subject ages, implants of various types and sizes in different anatomical locations, and types of BIA analyzers (e.g., single frequency, multifrequency, bioimpedance spectroscopy) or electrode configurations (e.g., tetrapolar, 8-segment).…”

Detecting and Monitoring Periprosthetic Joint Infection by Using Electrical Bioimpedance Spectroscopy: A Preliminary Case Study

“…Such a dramatic variation may not only be attributed to the presence of biofilm but more likely to surgical traumatic effects such as debridement, implant of spacer, fluid distribution, tissues removal, hematoma, etc. [ 26 , 27 ]. This is reflected in the measured higher impedance magnitude spectrum w.r.t.…”

Do metal implants for total hip arthroplasty affect bioelectrical impedance analysis? A retrospective study

“…However, the difference in electrical resistance and reactance was slight, and no signi cant difference was observed between the operated and non-operated limbs, or between preoperatively and postoperatively in this study. Other studies also performed BIA in patients with fracture [15][16][17]. Gonzalez-Montalvo et al performed BIA in patients with hip fractures in the rst 72 hours after admission and at discharge [16].…”

“…However, body composition after a fracture may be quite different from that of degenerative diseases because bleeding directly affects the water balance in the body and the result of BIA. Steihaug et al evaluated the effect of surgical implants in patients with hip fractures [17]. They compared the electrical impedance between the hospital stay and 3 months after surgery.…”