Posterior stabilized component increased femoral bone loss after total knee replacement. 5-year follow-up of 47 knees using dual energy X-ray absorptiometry

Clinical value of SPECT/CT in the painful total knee arthroplasty (TKA): a prospective study in a consecutive series of 100 TKA

“…Petersen et al found a 22 % increase proximal to the fixation pegs and a 36 % decrease of bone density behind the anterior femoral flange at 24 months after TKA [34,35]. Similar findings were reported by others [14,15,36]. Another study by Minoda et al showed that a cemented mobilebearing TKA has less bone loss in the distal femur than a cemented fixed-bearing TKA [17].…”

“…After TKA significant bone loss in the proximal tibia was found by several authors [14,15,19,37]. This bone loss was particularly high within the first 6 months and then decreased until 2 years after TKA [14,15,19,37]. Windisch et al highlighted that the highest bone loss after uncemented TKA was found within the first 3 months in the proximal medial tibia [16].…”

“…Many authors used bone densitometry for assessment of bone density around TKA [14][15][16][17]. In contrast to bone densitometry, in which only the density of bone is detected, SPECT/CT offers a window into the process of bone remodelling.…”

A cemented mobile-bearing total knee replacement prevents periprosthetic loss of bone mineral density around the femoral component

“…3 TKRs with posteriorly stabilised inserts have more reduction in BMD than those with other types of insert, such as cruciate-retaining implants. 3 The mobile-bearing TKR is designed to maximise conformity between the articulating components and to minimise constraint. It has been suggested that the mobility of the polyethylene insert reduces transmission of stress to the prosthesis-bone interface.…”

Aseptic loosening of femoral components – A review of current and future trends in materials used

“…Stress shielding, which causes bone loss, is not related to osteolysis but to bone remodeling, and it can be diagnosed as less bone mineral density adjacent to the implant. Several studies investigated femoral bone loss in the distal region for different designs of TKR preoperatively and postoperatively [35][36][37][38][39][40][41][42][43]. All these studies showed a considerable decrease in the amount of femoral bone density and determined the stress shielding effect as the main contributing factor to this density reduction.…”