A Review on Bone Mineral Density Loss in Total Knee Replacements Leading to Increased Fracture Risk

Gundry, Michael; Hopkins, Sue; Knapp, Karen

doi:10.1007/s12018-017-9238-4

Cited by 31 publications

(35 citation statements)

References 118 publications

(127 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The greatest loss of BMD, found in both the operated area and in the hip, was found within the first 3-6 months after surgery, levelling out from 2 years after the surgery [10]. The bone loss might be attributed to the presumed reduction in mobility after TKR [10]. A study of 238 persons with TKR revealed that there were only small changes in physical activity 6 months after TKR, and the activity level was still lower than in healthy controls after 1 year [24].…”

Section: Bmd Bmi Falls and Fracturementioning

confidence: 87%

“…A lower BMD after TKR has been shown in the majority of the studies conducted in this area [10]. The greatest loss of BMD, found in both the operated area and in the hip, was found within the first 3-6 months after surgery, levelling out from 2 years after the surgery [10]. The bone loss might be attributed to the presumed reduction in mobility after TKR [10].…”

Section: Bmd Bmi Falls and Fracturementioning

confidence: 97%

“…Individuals with osteoarthritis have been found to have high BMI, poorer bone strength and quality despite high BMD, and increased risk for both falls and fracture [10]. Though, some studies have instead found no increased or decreased risk for fracture [10,23]. Studies of the relationship between osteoarthritis, BMD, fall risk, and fracture risk have resulted in conflicting results [10].…”

Section: Bmd Bmi Falls and Fracturementioning

confidence: 99%

“…Though, some studies have instead found no increased or decreased risk for fracture [10,23]. Studies of the relationship between osteoarthritis, BMD, fall risk, and fracture risk have resulted in conflicting results [10].…”

Section: Bmd Bmi Falls and Fracturementioning

confidence: 99%

“…Today we know too little about the association between osteoarthritis, falls, and fractures. Several studies have reported an association between high bone mineral density (BMD) and osteoarthritis [10]. In contrast, other reports infer that both women and men with osteoarthritis also may have osteoporosis or osteopenia [11,12] and an increased risk of falls and fracture [10,11,13].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Risk for hip fracture before and after total knee replacement in Sweden

et al. 2019

View full text Add to dashboard Cite

We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.

show abstract

Section: Bmd Bmi Falls and Fracturementioning

confidence: 87%

Section: Bmd Bmi Falls and Fracturementioning

confidence: 97%

Section: Bmd Bmi Falls and Fracturementioning

confidence: 99%

Section: Bmd Bmi Falls and Fracturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk for hip fracture before and after total knee replacement in Sweden

et al. 2019

View full text Add to dashboard Cite

show abstract

The effect of periprosthetic bone loss on the failure risk of tibial total knee arthroplasty

Soltanihafshejani

Bitter

Janssen

2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

The effect of long‐term periprosthetic bone loss on the process of aseptic loosening of tibial total knee arthroplasty (TKA) is subject to debate. Contradicting studies can be found in literature, reporting either bone resorption or bone formation before failure of the tibial tray. The aim of the current study was to investigate the effects of bone resorption on failure of tibial TKA, by simulating clinical postoperative bone density changes in finite element analysis (FEA) models and FEA models were created of two tibiae representing cases with good and poor initial bone quality which were subjected to a walking configuration and subsequently to a traumatic stumbling load. Bone failure was simulated using a crushable foam model incorporating progressive yielding. Repetitive loading under a level walking load did not result in failure of the periprosthetic bone in neither the good nor poor bone quality tibia at the baseline bone densities. When applying a stumble load, a collapse of the tibial reconstruction was noticed in the poor bone quality model. Incorporating postoperative bone loss led to a significant increase of the failure risk, particularly for the poor bone quality model in which subsidence of the tibial component was substantial. Our results suggest bone loss can lead to an increased risk of a collapse of the tibial component, particularly in case of poor bone quality at the time of surgery. The study also examined the probability of medial or lateral subsidence of the implant and aimed to improve clinical implications. The FEA model simulated plastic deformation of the bone and implant subsidence, with further validation required via mechanical experiments.

show abstract

Component migration, bone mineral density changes, and bone turnover markers in cementless and cemented total knee arthroplasty: a prospective randomized RSA study in 53 patients with 2-year follow-up

Linde

Rytter

Søballé

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Cementless tibial components migrate initially until osseointegration and preserve periprosthetic bone. Cemented tibial components are ixed from surgery but loose periprosthetic bone. Little is known about bone formation and resorption biomarkers in relation to component ixation and bone mineral density (BMD) changes of cementless and cemented total knee arthroplasty. We hypothesize a similar migration of cemented and cementless tibial components between 1-and 2-year follow-up indicating a stable long-term ixation. MethodsIn a prospective patient-blinded randomized study, we compared cementless (n = 27) and cemented (n = 26) tibial components with radiostereometry measured migration (MTPM = Maximum Total Point Motion: point of component that migrates the most) and changes in BMD and biochemical bone turnover markers (BTMs) until 24 months after surgery. ResultsThe mean MTPM between 12 and 24 months were similar between groups with − 0.06 mm (95% CI − 0.23; 0.11) in the cementless group compared to 0.02 mm (95% CI − 0.07; 0.11) in the cemented group. However, there was a higher proportion of cementless components (16/25) than cemented components (7/24) with continuous migration (MTPM > 0.2 mm) (p = 0.02). In the medial and anterior region below the tibial components, the BMD increased by mean 1.8% and 7.4% for cementless components and decreased by mean 8.6% and 4.2% for cemented components until 24-month follow-up. In both groups, BTMs initially showed increased bone resorption (CTx) and bone formation (P1NP) followed by normalization to preoperative levels at 6 months post-surgery. ConclusionMore cementless components than cemented components showed continues migration which suggest a higher risk of early revision. Bone turnover increased post-surgery in both groups, but did not explain the diference in change in periprosthetic BMD. Level of evidence I. KeywordsKnee arthroplasty • Radiostereometry analysis • Bone mineral density • Bone turnover markers Abbreviations TKA Total Knee Arthroplasty OA Knee osteoarthritis RSA Radiostereometric analysis MTPM Maximum total point motion BMD Bone mineral density DXA Dual-energy X-ray absorptiometry BTMs Bone turnover markers CTx Collagen type 1 cross-linked C-telepeptide P1NP Type 1 procollagen N-terminal CR Cruciate retaining * Karina Nørgaard Linde

show abstract

A Review on Bone Mineral Density Loss in Total Knee Replacements Leading to Increased Fracture Risk

Cited by 31 publications

References 118 publications

Risk for hip fracture before and after total knee replacement in Sweden

Risk for hip fracture before and after total knee replacement in Sweden

The effect of periprosthetic bone loss on the failure risk of tibial total knee arthroplasty

Component migration, bone mineral density changes, and bone turnover markers in cementless and cemented total knee arthroplasty: a prospective randomized RSA study in 53 patients with 2-year follow-up

Contact Info

Product

Resources

About