Long-Term Changes in Bone Mineral Density Following Total Knee Replacement

Levitz, Craig L.; Lotke, Paul A.; Karp, Joel S.

doi:10.1097/00003086-199512000-00010

Cited by 44 publications

(66 citation statements)

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“…Tibial bone loss can be caused by load changes on the metaphyseal bone, and long-term studies show that after an initial stable period, the bone density of the proximal tibia consistently decreased at a rate of 5% per year [6]. Our results did not coincide with these findings.…”

Section: Discussioncontrasting

confidence: 76%

Influence of the tibial stem design on bone density after cemented total knee arthroplasty: a prospective seven-year follow-up study

Hernández-Vaquero

García-Sandoval

Fernández-Carreira

et al. 2006

International Orthopaedics (SICO

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We prospectively measured the changes in bone mineral density (BMD) in the proximal tibia of 20 total knee arthroplasties, ten with cruciform stems and ten with cylindrical stems. The measurements were made one, four and seven years after surgery. We observed a uniform density decrease in three regions of interest from one to seven years of follow-up. Cylindrical stems showed an asymmetrical density decrease between the three regions of interest, with no change in the central region, a slight decrease in the lateral region, and large decrease in the medial region. Multivariate analysis with general linear model showed the stem type factor as statistically significant for medial region of interest (p=0.006). The cylindrical stem produces heterogeneous BMD changes under the tibial platform in knee arthroplasties, and this could be a potential risk factor for asymmetrical subsidence of this component. Résumé Nous avons de façon prospective mesuré les modifications de la densité minérale osseuse (BMD) au niveau de la partie proximale du tibia chez 20 patients ayant bénéficié d'une prothèse totale du genou, 10 avec une quille cruciforme et 10 avec une quille cylindrique. Les mesures ont été réalisées de 1.4 à 7 ans après l'intervention chirurgicale. Nous avons observé une diminution uniforme de la densité minérale osseuse dans trois zones, durant cette période de 1 à 7 ans de suivi. La quille cylindrique montre que la densité minérale osseuse diminue de façon asymé-trique dans ces 3 régions sans modification au niveau de la région centrale, avec une légère diminution de la région externe (latérale) et une diminution plus importante de la région interne (médiale). Une analyse de régression multi variable montre que le type de quille est l'élément le plus significatif au niveau de la région interne (p=0.006). La quille cylindrique étant un facteur statistiquement significatif et entraînant des modifications hétérogènes de la BMD, sous le plateau tibial. Ces modifications peuvent être un risque potentiel de migration du composant tibial.

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Section: Discussioncontrasting

confidence: 76%

Influence of the tibial stem design on bone density after cemented total knee arthroplasty: a prospective seven-year follow-up study

Hernández-Vaquero

García-Sandoval

Fernández-Carreira

et al. 2006

International Orthopaedics (SICO

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“…The extent of this process influences the load distribution between the tibial component and the underlying bone, and consequently affects bone remodeling. A decrease in the amount of bone mineral beneath the tibial tray has been reported in several studies , Petersen et al 1994, Levitz et al 1995. After 2 years, this decrease has amounted to 11%-14% in uncemented and cemented total knee arthoplasties , Petersen et al 1995.…”

Section: Peter G Herbertsl and Janos Swanpalme6mentioning

confidence: 86%

Bone mineral and migratory patterns in uncemented total knee arthroplasties: A randomized 5-year follow-up study of 38 knees

Regnér

Carlsson

Kärrholm

et al. 1999

Acta Orthopaedica Scandinavica

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“…Most authors mention that bone mass loss following arthroplasty [6,9,12,15,18] stabilises after 1 year and then decreases [3,9,18]. Our study revealed a non-significant drop in BMD after 6 months in 80% of the areas studied in both knees, and that this was related to factors such as postoperative trophic disorders, reduced muscular activity and assisted loading.…”

Section: Discussionmentioning

confidence: 45%

“…The greatest changes in bone around porous implants occur during the 1st year after arthroplasty [3,9,16,18]. Knee bone mass decreases in the first 3 months, but does this 'fall-off' continue [6,12,13,15], or are the preoperative levels restored [3,9,18]?…”

Section: Introductionmentioning

confidence: 99%

“…Knee bone mass decreases in the first 3 months, but does this 'fall-off' continue [6,12,13,15], or are the preoperative levels restored [3,9,18]? Most authors conclude that there is a bone mass loss behind the femoral shield [8,10,11,13,14,15] and this is the reason that we studied bone mineral density variations at the femoro-patellar interface and in the region of the insertion of the patellar ligament.…”

Section: Introductionmentioning

confidence: 99%

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Muscular function and bone mass after knee arthroplasty

Anchuela

Gomez-Pellico

Ferrer-Blanco

et al. 2001

International Orthopaedics (SICOT)

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We report a study of 28 women with severe primary gonarthrosis followed for 1 year. Variations in bone mineral density and in functional behaviour of knee extensors and flexors were studied before and after implantation of uncemented total knee prosthesis. A functional deficit was noted in the extensor apparatus, which increased in the first 6 months following surgery. This strength was not improved 1 year following the arthroplasty, but it was more efficient as shown by the reduction of muscle fatigue. Flexor strength was conserved and a pathological muscle balance was maintained, reaching maximum efficiency over a smaller joint range.Résumé Etude des variations de la densité minérale osseuse et du comportement des extenseurs et fléchisseurs du genou avant et après implantation d'une prothèse totale non cimentée chez 28 femmes souffrant d'une gonarthrose primaire sévère et suivies pendant une année. Un déficit fonctionnel de l'appareil de l'extenseur à été noté avant l'intervention et a augmenté dans les six premiers mois suivant la chirurgie. La force d'extension n'était pas améliorée une année après l'arthroplastie, mais l'action était meilleure à cause d'une moindre fatiguabilité du muscle. La force des fléchisseurs a été conservée et un équilibre musculaire a été maintenu, en arrivant à l'efficacité maximale sur une plus petite amplitude articulaire.

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Long-Term Changes in Bone Mineral Density Following Total Knee Replacement

Cited by 44 publications

References 0 publications

Influence of the tibial stem design on bone density after cemented total knee arthroplasty: a prospective seven-year follow-up study

Influence of the tibial stem design on bone density after cemented total knee arthroplasty: a prospective seven-year follow-up study

Bone mineral and migratory patterns in uncemented total knee arthroplasties: A randomized 5-year follow-up study of 38 knees

Muscular function and bone mass after knee arthroplasty

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