Stress Fracture of the Femoral Neck as a Complication of Total Knee Arthroplasty

Joshi, Nayana; Pidemunt, G.; Carrera, Lluís; Navarro-Quilis, Antonio

doi:10.1016/j.arth.2004.09.044

Cited by 17 publications

(18 citation statements)

References 10 publications

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“…In addition, factors directly and indirectly related to TKA, such as less recovery of range of motion and decrease of periprosthetic BMD, did not influence either hip differently. In considering these results, a decrease in postoperative BMD is not a direct cause of ipsilateral femoral neck stress fracture after TKA 1-5). We deem there could be another cause, such as the occurrence of femoral neck microfracture intraoperatively because of hammering or forceful manipulation in osteoporotic patients.…”

Section: Discussionmentioning

confidence: 93%

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Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty

et al. 2014

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BackgroundThis study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure.MethodsForty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides.ResultsPreoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time.ConclusionsAccording to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.

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Section: Discussionmentioning

confidence: 93%

“…With increased demand of daily activity, microfractures during surgery due to hammer blows, the design of prosthesis, and decreased bone mineral density (BMD) after TKA, a few hypotheses regarding the etiologies of femoral neck stress fractures have been proposed 1-5). However, reports regarding changes of BMD in the proximal hip after TKA have been rare 6,7).…”

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confidence: 99%

Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty

et al. 2014

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“…Subcapital stress fracture of the femoral neck has been described in association with pathologic changes of RA or osteoporosis, and in patients with prolonged steroid treatment. 24 Changes in the weight-bearing axis of the extremity after total knee arthroplasty in patients with large deformities of the knee are likely to concentrate distraction forces in the superior cortex of the femoral neck.…”

Section: Discussionmentioning

confidence: 99%

Proximal femoral fracture in patients with rheumatoid arthritis

et al. 2007

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Hip fracture occurrence was examined cross-sectionally in Japanese patients with rheumatoid arthritis (RA). Between January 2005 and June 2006 we studied RA outpatients with a past history of hip fractures. Patients included 1 man and 25 women. As 3 women had bilateral hip fractures, the total number was 29. Age at the time of fracture was 72.1 +/- 4.5 years. Of the 29 fractures, 22 were cervical and 7 were trochanteric. Four fractures were spontaneous while the others occurred in falls. 24 fractures were associated with oral steroid administration. All 5 fractures unassociated with prednisolone were cervical. Of the 26 patients, 8 were taking bisphosphonate when fracture occurred. Cervical fracture was treated with total hip arthroplasty in 1 patient whose hip showed RA changes. In others whose hip joint lacked RA change, procedures included osteosynthesis in 2 patients with good function over 6 years; and hemiarthroplasty with a bipolar system in 19 displaced fractures, with good function over 4.1 years. Osteosynthesis was performed for all 7 trochanteric fractures. Trabeculae were thin, and fewer transverse trabeculae could be found in specimens from cervical fracture. Hip fracture in RA patients occurred 10 years earlier than in the general population, and many fractures were cervical.

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“…Joshi et al[16] reported 4 cases of ipsilateral fracture of the femoral neck after TKR. They explained possible mechanisms of fractures are due to changes in the weight bearing axis of the extremity and poor mobility and weakened bones.…”

Section: Discussionmentioning

confidence: 99%

Bone Mineral Density Changes after Total Knee Replacement in Women Over the Age of 65

Hahn

Won

2013

J Bone Metab

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BackgroundThere are few reports on bone mineral density (BMD) changes of axial bones after total knee replacement (TKR) due to severe osteoarthritis (OA) of the knee joint and its results are controversial. The purpose of our study was to measure the BMD changes of hip and spine in patients receiving TKR due to severe OA and to identify clinical factors relating BMD changes.MethodsAmong 66 female patients above 65 years old who underwent TKR due to severe OA and checked preoperative BMD, 52 patients who checked 1 year follow up BMD were enrolled. We investigated the association of the BMD changes with bilaterality of operation, obesity, preoperative knee functional scores, bisphosphonate medication, and diagnosis of osteoporosis.ResultsWe found no correlation between BMD changes and bilaterality of operation, obesity, preoperative knee functional scores and diagnosis of osteoporosis. Spine BMD increased in non-treatment and bisphosphonate treatment group but total hip BMD significantly increased in bisphosphonate treatment group.ConclusionsBisphosphonate treatment for 1 year prevents early reduction of hip BMD just after TKR regardless osteoporosis diagnosis. We considered that the bisphosphonate medication would be beneficial to prevention of later hip fracture in elderly patient receiving TKR due to severe OA of knee joints.

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Stress Fracture of the Femoral Neck as a Complication of Total Knee Arthroplasty

Cited by 17 publications

References 10 publications

Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty

Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty

Proximal femoral fracture in patients with rheumatoid arthritis

Bone Mineral Density Changes after Total Knee Replacement in Women Over the Age of 65

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