Changes in bone mineral density of the distal femur after total knee arthroplasty: A 7-year DEXA follow-up comparing results between obese and nonobese patients

Järvenpää, Jaakko; Soininvaara, Tarja; Kettunen, Jukka; Miettinen, Hannu; Kröger, Heikki

doi:10.1016/j.knee.2013.03.004

Cited by 43 publications

(35 citation statements)

References 21 publications

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“…Stets et al 26 also found that only 21.5% of their patients presented a reduction in BMI; in the other patients, weight was maintained (59.2%) or increased (19.9%). Regarding obese patients, Järvenpää et al 27 observed a lower loss of periprosthetic bone mineral density in the postoperative period, probably related to a greater induced stress due to high body weight.…”

Section: Discussionmentioning

confidence: 99%

Do patients lose weight after total knee replacement?

Schwartsmann

Borges

Freitas

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveSeveral studies show that patients undergoing total knee arthroplasty (TKA) tend to maintain or gain weight after the procedure, which would result in increased wear of the prosthesis and new surgical interventions in a smaller period of time in comparison with patients with adequate body mass index (BMI). The aim of this study was to investigate the effect of TKA surgery on these patients’ BMI.MethodsInitially the records were analyzed, chosen at random from 91 patients undergoing TKA during the period from August 2011 to July 2013. Patients were stratified by BMI as normal weight (BMI between 20 and 25), overweight (BMI between 25 and 30), and obesity (BMI > 30). They were re-evaluated in a minimum period of 18 months.ResultsThe mean age of the sample population was 68.1 years; 69.1 for men and 67.2 for women. The mean preoperative BMI was 27.24 kg/m2. Among the study participants, in the preoperative period, 17 patients had normal weight, 65 were overweight, and nine were obese. Postoperative analysis showed weight loss in 41 patients (46%), and weight gain in 50 patients (54%). The mean postoperative BMI was 27.16 kg/m2, in general, experiencing a slight decline in the mean BMI of 0.08 kg/m2.ConclusionPatients who underwent TKA did not achieve significant reduction in BMI after surgery.

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Section: Discussionmentioning

confidence: 99%

Do patients lose weight after total knee replacement?

Schwartsmann

Borges

Freitas

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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“…Järvenpää et al indicated that the highest bone-loss rates occurred during the first three postoperative months after TKA, and continued around the femoral component for up to 7 years. The clinical outcome, ass quantified by the improvement in a functional score, was not associated with peri-prosthetic BMD change (11,12,25). A variable prosthesis-related stress-shielding and different patient's muscle mass could be possible explanations to these differences, as proposed Mau-Moeller et al after comparing DXA, muscle mass and strength ten days and three months after surgery in 23 patients undergoing TKA (26).…”

Section: Accepted Manuscriptmentioning

confidence: 94%

A Prospective Assessment of Periprosthetic Bone Mineral Density and Osteoimmunological Biomarkers Variations After Total Knee Replacement Surgery

Cucchi

Menon

Galliera

et al. 2019

Journal of Clinical Densitometry

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Aseptic loosening is a major cause of premature failure of total knee replacement (TKR). Variations in periprosthetic bone mineral density (BMD) and osteoimmunological biomarkers levels could help to quantify prosthesis osteointegration and predict early aseptic loosening. The gene expression of 5 selected osteoimmunological biomarkers was evaluated in tibial plateau bone biopsies by real-time polymerase chain reaction and changes in their serum levels after TKR were prospectively evaluated with enzyme-linked immunosorbent assay for 1 yr after surgery. These variations were correlated to changes in periprosthetic BMD. Sixteen patients were evaluated. A statistically significant decrease in serum levels of Sclerostin (p = 0.0135) was observed immediately after surgery. A specular pattern was observed between dickkopf-related protein 1 and osteoprotegerin expression. No statistically significant changes were detectable in the other study biomarkers. Periprosthetic BMD did not change significantly across the duration of the follow-up. Prosthetic knee surgery has an impact on bone remodeling, in particular on sclerostin expression. Although not showing statistically significant changes, in the patterns of dickkopf-related protein 1, osteoprotegerin, and the ligand of the receptor activator of nuclear factor kappa-B symmetries and correspondences related to the biological activities of these proteins could be identified. Variation in osteoimmunological biomarkers after TKR surgery can help in quantifying prosthesis osteointegration.

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“…The preoperative BMD values from patients undergoing TKA surgery were previously reported at the proximal femur and lumbar spine [4, 14-16]. In some cases, the periarticular BMD of the knee joint was evaluated on the femoral side [14, 17], the tibial side [15, 18-20], or on both sides [21-23].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Periarticular Knee Bone Mineral Density in Osteoarthritic Patients Undergoing TKA

Ishii¹,

Noguchi²,

Sato³

et al. 2016

TOORTHJ

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Background:Preoperative periarticular bone quality is affected by joint loading. The purpose of this study was to determine the periarticular bone mineral density of the knee joint of patients undergoing total knee arthroplasty, and whether the location of the load-bearing axis correlates with the measured bone mineral density.Materials and Methods: The bone mineral densities of the medial and lateral femoral condyles and the medial and lateral tibial condyles were analyzed in consecutive 116 osteoarthritic patients (130 knees) by dual energy x-ray absorptiometry.Results: The median bone mineral density values in the condyles were 1.138 in femoral medial, 0.767 in femoral lateral, 1.056 in tibial medial, and 0.714 in tibial lateral. The medial condyles showed significantly higher bone mineral densities than the lateral condyles in both the femur and tibia. In addition, the femoral medial showed significantly higher bone mineral density levels than the tibial medial, and the femoral lateral condyle had higher bone mineral density levels than the tibial lateral. The bone mineral density Medial/Lateral ratio was significantly negatively correlated with the location (tibial medial edge 0%, lateral edge 100%) of the load-bearing axis in the femur and tibia.Conclusion: Preoperative bone mineral density values may provide against the changes in bone mineral density after total knee arthroplasty by reflecting the correlation with joint loading axis. These results help explain why total knee arthroplasty has such good long-term clinical outcomes with a low frequency of component loosening and periarticular fractures despite a high degree of postoperative bone loss.

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Changes in bone mineral density of the distal femur after total knee arthroplasty: A 7-year DEXA follow-up comparing results between obese and nonobese patients

Cited by 43 publications

References 21 publications

Do patients lose weight after total knee replacement?

Do patients lose weight after total knee replacement?

A Prospective Assessment of Periprosthetic Bone Mineral Density and Osteoimmunological Biomarkers Variations After Total Knee Replacement Surgery

Preoperative Periarticular Knee Bone Mineral Density in Osteoarthritic Patients Undergoing TKA

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