Inter-observer validation study of quantitative CT-osteodensitometry in total knee arthroplasty

Reilly, Keryn; Munro, Jacob T.; Pandit, Salil; Kreß, Alexander; Walker, Cameron; Pitto, Rocco P.

doi:10.1007/s00402-007-0351-6

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…Furthermore, ultrasound techniques are highly dependent on the examiners experience. BMD measurements with CT-osteodensitometry, however, showed to be very reproducible with little variation between observers [22]. Direct mechanical measurement of the break away torque of cancellous bone at the femoral head would be an intraoperative option to determine local bone quality.…”

Section: Discussionmentioning

confidence: 96%

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures

Erhart

Zegg

Kralinger

et al. 2015

Arch Orthop Trauma Surg

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The proposed method is an easily applicable, reliable and useful tool to estimate bone quality preoperatively using the contralateral hip as a reference. Obtained data may facilitate the decision-making towards the use of further therapeutic measures to improve implant anchorage in osteoporotic bone such as bone cement augmentation. Thus, our method allows for a more individualized surgical treatment of hip fracture patients adapted to the estimated cancellous bone quality of the patient.

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Section: Discussionmentioning

confidence: 96%

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures

Erhart

Zegg

Kralinger

et al. 2015

Arch Orthop Trauma Surg

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“…CT scans were performed within 7 days after surgery to establish baseline BMD and again at 1 and 2 years after the index procedure. We used quantitative CT to measure BMD because the method is accurate and reproducible about the hip and the knee [12,21,25]. Hounsfield units (HUs) obtained from conventional CT scans correlate with BMD values obtained from dualenergy x-ray absorptiometry [26].…”

Section: Methodsmentioning

confidence: 99%

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Richmond

Hadlow

Lynskey

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Bone mineral density (BMD) in the proximal tibia decreases after TKA and is believed to be a factor in implant migration and loosening. Unicompartmental knee arthroplasty (UKA) is a less invasive procedure preserving knee compartments unaffected by degeneration. Finite element studies have suggested UKA may preserve BMD and that implants of differing stiffnesses might differentially affect BMD but these notions have not been clinically confirmed. Questions/purposes We therefore asked whether (1) proximal tibial BMD decreases after UKA, and (2) a cemented metal tibial component with a mobile polyethylene (PE) bearing would have greater BMD loss than a cemented PE tibial component. Methods We prospectively followed 48 patients who underwent 50 UKAs using one of two implants: one with a cemented metal tibial baseplate and a mobile PE insert (n = 26) and one with a cemented all-PE tibial component (n = 24). In followup we assessed pain and function (Oxford Knee Score, SF-12, The Knee Society Score Ó ) and radiographs. BMD changes were assessed using quantitative CT osteodensitometry performed postoperatively and at 1 and 2 years after the index procedure. Results Mean cancellous BMD decreased 1.9% on the medial side and 1.1% on the lateral side. Mean cortical BMD was static, decreasing 0.4% on the medial side and increasing 0.5% on the lateral side. The greatest observed difference between implants for any region was 3.7%. There were no differences in pain or functional outcome scores. Conclusions BMD was preserved 2 years after UKA with no major differences seen between implant types.

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“…However, it is not clear whether there are differences in BMD changes between cortical and cancellous bone. In contrast to DEXA, qCT-assisted osteodensitometry offers three-dimensional, volumetric analysis of cortical and cancellous regions independently and is accurate and reliable about the hip [14,15,18] and knee [16].…”

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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Inter-observer validation study of quantitative CT-osteodensitometry in total knee arthroplasty

Abstract: Quantitative CT-osteodensitometry is a reproducible method to measure bone mineral density changes about the knee and shows little variation between observers.

Cited by 4 publications

References 7 publications

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

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

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